bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of FDM Parameters on the Mechanical Properties of PLA Printed Parts
Authors: Ahmad Mohd Nazri , Ishak Mohamad Ridzwan , Zulkafle Hannah Muhammad Zulfikri
Published: September 2024

The most common method for additive manufacturing of thermoplastics is fused deposition modeling (FDM), which is becoming a growing trend in a variety of engineering applications since it can easily create intricate parts. The appropriate choice of process parameters has a significant impact on the mechanical qualities of 3D-printed parts. This study examined the effect of four crucial process variables on the tensile strength of polylactic acid (PLA) samples: infill density, printing speed, build orientation, and layer thickness. Samples were printed in accordance with ASTM D638 using an FDM 3D printer. The findings of this study show that the tensile strength of the PLA-printed samples is highly influenced by factors such as layer thickness, build orientation, and infill density. The PLA-printed samples' tensile strength and Young's modulus were significantly affected by the 90° orientations, hollow infill, 0.4 mm thickness, and 100 mm/s speed. Therefore, as the FDM 3D printer becomes progressively more significant for manufacturing engineering components, finding the parameter values that may lead to stronger mechanical and physical characteristics would definitely help designers and manufacturers globally.
Moisture Sensitivity Performance of Hot Mix Asphalt Mixture Incorporating Fly Ash Geopolymer (FAG) Asphalt Binder
Authors: Bujang Hazirah , Aman Mohamad Yusri , Mohamad Taher Mohammad Nasir , Shapie Sinatu Sadiah
Published: September 2024

In Malaysia, Hot Mix Asphalt (HMA) is widely used in asphalt production. HMA is a mixture of asphalt and aggregates that give durability to the road surface for pavement. Due to vehicles excessive traffic loadings that cause road surface damage, this pavement technology frequently undergoes maintenance and rehabilitation work. This study used recycled material as a modified binder and showned the best result in increasing stiffness and better rutting performance with high percentages of additives. This research focuses on the effect of FAG additive on asphalt mixture performance evaluation according to SuperpaveTM mixes design method. The procedures were specified according to the American Association of State Highway and Transportation Officials (AASHTO), American Society for Testing and Materials (ASTM), British Standard (BS) and Malaysian Standard (MS). The granite aggregate type was produced by a local quarry with conventional asphalt binder grade 80/100 and 60/70. Incorporation FAG in modified asphalt binder as levels of 0, 3, 5, 7, 9, and 11% by mass of asphalt binder. The performance of moisture sensitivity showed low moisture damage susceptibility for the mixture based on consistent values of TSR, in which all the specimens met the minimum TSR threshold of 80%. The optimization findings indicated that 9% of fly ash geopolymer might be the ideal content for modifying the asphalt binder. Overall, research findings suggest that using geopolymers may have improved some of the characteristics of asphalt binder and the performance of asphalt binders in pavement applications.  Thus, the outcomes of this research were significantly used for further performance test and analysis on the asphalt mixture.
The Effect of Di-Ammonium Phosphate (DAP) towards Flammability Properties of Polyester-Cotton Military Fabrics
Authors: Mohd Yunos Muhammad Nur Annuar , Yahaya Ridwan , Mohd Rahimi Mohamad Ridzuwan , Shahadan Muhammad Shahsyimir , Nadzira Nurfarhanah , Raj Ravin
Published: September 2024

Polyester-cotton fabric is one of the most common materials used in military fabrics. The study of the suitable fabric material is critical because military personnel must prepare themselves from inevitable events such as heat exposure. Therefore, the purpose of this study was to examine the flammability features of various cotton compositions in polyester-cotton military textiles with and without the presence of Di-ammonium Phosphate (DAP). We performed a full flammability test, including a cone calorimeter test and a limited oxygen index (LOI) test on three distinct types of polyester-cotton textiles treated with 10% di-ammonium phosphate (DAP). The result shows that, the higher the percentage of cotton, the lower the fire-retardant properties. Besides that, this study also found that the di-ammonium phosphate (DAP) improves the flammable properties of the military fabric.
Identification of Power Quality Disturbances in Electrical Distribution System using Fast Fourier Transforms and Super Learner Ensembles
Authors: Janthong Supakan , Phukpattaranont Pornchai
Published: September 2024

Currently, the use of non-linear loads and equipment, as well as renewable energy sources injected into the power system, tends to increase. As a result, the waveform of the electrical signal changes, and distortion occurs in the distribution system, which affects the quality and reliability of the electrical system. Importantly, sometimes this leads to malfunctions in protection equipment. This paper presents the algorithm for power quality disturbance (PQD) identification in electrical distribution systems, which involves three main steps: (1) Generating simulated waveforms using a signal processing approach; (2) extracting features using the Fast Fourier Transforms (FFT) technique; and (3) identifying the type of PQD using Super Learner Ensembles (SLE), which employs cross-validation to assess the performance of multiple machine learning models. Subsequently, the model’s efficiency is verified and tested using data from electronic energy meters installed in the distribution system of the Provincial Electricity Authority (PEA). The accuracy resulting from synthetic and experimental data sets is 99.90% and 99.69%, respectively. The results indicate that the model performs well in identifying power quality disturbances and achieves high accuracy.
Exploring Novel Approaches: Surface Functionalization of Metal Organic Semiconductor as Sensing Material for Volatile Organic Compounds Detection
Authors: Khairunnisa Waznah Baharin  , Nurul Hazwani Aminuddin Rosli  , Mohd Nurazzi Norizan  , Mohd Afzanizam Mohd Rosli  , Noor Aisyah Ahmad Shah  , Safura Taufik  , Nor Ain Azeany Mohd Nasir  , Syed Mohd Shafiq Syed Ahmad  , Norli Abdullah
Published: September 2024

Detecting volatile organic compounds (VOCs) is imperative in healthcare, industrial safety, and environmental monitoring due to their potential harm to human health and the environment. Addressing the challenges in VOC detection, research has focused on creating sensors with rapid response and high selectivity, notably through surface functionalization of metal organic semiconductors. Metal organic semiconductors offer advantages over standard metal oxide semiconductors (MOS), demonstrating superior sensitivity and selectivity even at low temperatures and concentrations. Notably, conductive particle-polymer hybrids and conjugated polymers as metal organic semiconductors show promise for VOCs detection. This review comprehensively explores surface functionalization in metal organic semiconductors, covering principles, mechanisms governing gas sensing behavior and the pivotal role of surface functionalization in enhancing selectivity and performance. Additionally, various surface functionalization options, such as nanoparticles, nanostructures, and organic ligands, are discussed.
Compromiso de arteria renal en paciente con arteritis de Takayasu: reporte de caso y revisión de literatura
Authors: Yepes Madrid Nathalie , Gómez Mora María Del Pilar , Gomez Urrego Jose Fernando , Endo Cáceres Jorge Alberto
Published: August 2024

Introducción: La arteritis de Takayasu (TAK) es una enfermedad idiopática granulomatosa de grandes vasos que afecta predominantemente a la aorta, ramas arteriales principales y pulmonares. La prevalencia es mayor en adultos que en niños, con una incidencia de 1,1 por millón de personas. Su etiología sigue siendo poco conocida. Caso Clínico: Se presenta el caso de un paciente pediátrico con pérdida de la masa renal izquierda por disminución del calibre de arteria renal ipsilateral meses después del debut de la Arteritis de Takayasu como aneurisma de aorta abdominal. El paciente cumple criterios de TAK según clasificación EULAR/PRINTO/PReS basados en anomalía angiográfica, hipertensión arterial y elevación reactantes de fase aguda. La TAK presenta afectación sistémica y alteraciones cardiovasculares (75-85%), hipertensión en más del 80% de los casos, con estenosis de la arteria renal en casi el 50% de los pacientes. Conclusiones: El tratamiento general de la TAK está dirigido a controlar la inflamación vascular y prevenir el daño orgánico irreversible. A pesar de un diagnóstico temprano con tratamiento oportuno y agresivo el seguimiento en la enfermedad de Takayasu es imprescindible dado que la progresión de esta puede seguirse dando. Deben establecerse estrategias para asegurar la adherencia al seguimiento.
İklim Değişikliğine Uyum ve Afet Risk Yönetimi Bağlamında Bir Değerlendirme
Authors: Tazegül Bekci Ayşe , Şahinöz Saime
Published: September 2024

İklim değişikliği, etkili uyum ve risk yönetimi stratejileri gerektiren ve giderek karmaşıklaşan bir sorundur. İklim değişikliğinin artan küresel sıcaklıklar, deniz seviyesinin yükselmesi ve aşırı hava olayları gibi etkileri, ekosistemler ve insan toplulukları için önemli sonuçlar doğurmaktadır. İklim değişikliğine uyum ve afet risk yönetiminin entegrasyonu, bu riskleri azaltmak ve sürdürülebilir kalkınma hedeflerine ulaşmak için çok önemlidir. Bu makale, iklim değişikliğine uyum konusunu gözden geçirmekte, iklim değişikliğine uyum ve afet risk yönetimi arasındaki ilişkiyi değerlendirmekte, dirençli ve sürdürülebilir kalkınma için bir değerlendirme sunmaktadır. İklim değişikliğine uyumun, afet risk yönetiminin bir alt kümesi olmadığını, kapsam ve odaklanma açısından benzerlik ve farklılıkları olduğunu, afet ve iklim değişikliği risklerini azaltmak için, yönetişim mekanizmalarının iklim değişikliğine uyum ve afet risk yönetimini entegre edecek şekilde dönüştürülmesi gerektiğini vurgulamaktadır.
Introducing Religious Moderation through Local Wisdom for Early Childhood
Authors: Lestari Dwi Puji , Nopiana Nopiana
Published: September 2024

Various cases of suicide bombings in several regions in Indonesia, terrorism movements, the development of thought dynamics that cause various differences, and various issues of intolerant practices that occur at the kindergarten/PAUD level. Conflicts arising from diversity in Indonesia pose a significant challenge to the country’s ability to maintain unity. The purpose of this study is to explain the strategy for introducing religious moderation through local wisdom in early childhood. The research methodology employs a qualitative literature review method. We gather documentation data by searching through a variety of books and articles using keywords such as religious moderation, early childhood, and local wisdom. The data analysis process employs content analysis, which involves scrutinizing data from a variety of sources and drawing conclusions from the findings. The study’s findings demonstrate that local wisdom can introduce religious moderation, as it closely aligns with the child’s surroundings, making religious moderation an integral part of children’s lives. Family, school, and community education can facilitate the integration of moderation and local wisdom. This study offers a fresh perspective on the strategy of introducing religious moderation to early childhood by integrating local wisdom values to form an inclusive, tolerant, and open character towards diversity.
Fostering Resilience: The Symbiotic Relationship Between Entrepreneurship and Sustainability
Authors: Rizwan Ul Haque Muhammed
Published: September 2024

This study explores the intersection of entrepreneurship and sustainability, focusing on how businesses can integrate environmental, social, and cultural considerations into their operations to drive sustainable development. By examining the role of sustainable entrepreneurship, the research highlights the transformative potential of integrating the triple bottom- line framework, which encompasses economic prosperity, environmental stewardship, and social equity. The study utilises qualitative methods, including case studies and theoretical analysis, to investigate how entrepreneurial ventures can achieve competitive advantages through sustainable practices. Key findings reveal that businesses with high entrepreneurial orientation marked by innovation, risk-taking, and proactiveness are more likely to implement sustainable strategies contributing to long- term economic growth and societal well-being. The research underscores the importance of a holistic approach that balances economic, environmental, social, and cultural dimensions, emphasising the need for businesses to align their strategies with sustainable development goals to ensure resilience and relevance in a rapidly changing global landscape.
Prevalence and Risk Factors of Psychiatric Symptoms among Type 2 Diabetes Mellitus Patients in South India: A Cross-Sectional Study.
Authors: Utchimahali Suguna , Kannan S. , Velayutham Kumaravel
Published: September 2024

Background: Type 2 diabetes mellitus poses a momentous challenge when accompanied by psychiatric symptoms like depression, anxiety, and stress, adding to the complaint's threat. Research on these factors in patients with uncontrolled chronic illnesses in India, particularly in Tamil Nadu, is limited. Hence, this study aims to determine the prevalence and risk factors of these psychiatric symptoms among Type 2 diabetes patients.  Methods: A cross-sectional study was conducted in Alpha Hospital and Research Center in Madurai, South India, from April 2020 to March 2021, enrolling 614 participants (307 with Type 2 diabetes mellitus and 307 general population). Data were collected using Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale and Perceived Stress Scale. The IBM SPSS version 23 was used for statistical analysis.  Results: Two-thirds of youth women with type 2 diabetes have higher fasting blood sugar levels than men when compared to general population. 82.61% of patients with uncontrolled diabetes developed severe stress, surpassing those with well-controlled and pre-diabetes. Severe depression is most prevalent among patients with neuropathic foot ulcers (54.76%) and nephropathy (61.54%). Predominant mental health risk factors include being single, high school education, poor glycemic control, comorbid hypertension, and family history. Interestingly, lifestyle factors like alcohol use and smoking positively impact mental health outcomes.  Conclusion: This study shows the intricate connection between Type 2 diabetes and mental health problems in Madurai, emphasizing the necessity for a multidisciplinary strategy to enhance outcomes and reduce financial burden. Future research in nursing has to focus on implementing and assessing therapies aimed at reducing patients' stress, anxiety and depression.
Effect of Bi2O3, B2O3 and V2O5 Sintering Additives on Phase Composition, Microstructure and Electrical Resistivity of SrAlFe11O19 Ceramics
Authors: Volodina Natalia , Maznykh Sofiya , Vinnik Denis , Trukhanov Alex V. , Kozlovskiy Artem L.
Published: September 2024

Sintering aids play a crucial role in enhancing the properties of various ceramics, offering benefits such as increased density, lowered sintering temperatures, and changes in material electrical characteristics. This study focuses on investigating the impact of 3 wt.% additions of Bi2O3, B2O3, and V2O5 on the structural, morphological, and electrical properties of hexaferrite SrAlFe11O19 ceramics, known for their significance in microwave applications. Obtained by conventional solid-state synthesis, ceramic samples were subjected to X-ray diffraction (XRD) analysis, Raman spectroscopy, scanning electron microscopy (SEM), and resistivity measurements. Results revealed that the addition of Bi2O3 and V2O5 effectively reduced porosity in hexaferrite ceramics, which can potentially increase the magnetization values of ferrite material. Notably, the sample with 3 wt.% of B2O3 exhibited the highest resistivity, reaching 1.9·107 Ω·cm. These findings suggest that incorporating specific sintering aids can help in achieving controlled conductivity and magnetization in hexaferrite ceramics, which is particularly beneficial for microwave components like inductors, antenna substrates, and circulators.
Extended Finite Element Simulation of Axial Semi Elliptical Surface Crack in Bi-Material Pipe
Authors: Bhattacharya Somnath , Sonkar Vaibhav
Published: September 2024

Fracture analysis of crack is very essential to ensure the reliability and avoid the catastrophic failure of engineering components and structures since most of the failures start from the crack which leads to loss of life and economy. In the present study, extended finite element method (XFEM) is used to simulate the axial surface crack in bi-material pipe. Bi-material consists of two dissimilar materials with distinct properties. In this study, bi-material pipe consists of inner pipe made of steel alloy and outer pipe made of ceramic. An axial semi elliptical part through crack at different location is used for 3D linear elastic fracture mechanics (LEFM) analysis of bi-material pipe. Bi-material pipe is subjected to internal pressure and stress intensity factor (SIF) is computed at different location of crack front of semi elliptical surface crack using virtual domain extension approach.
Combined Influence of a Liner Deformation and Couple Stresses on the Partial Bearing Aspect Ratios
Authors: Kumar Vinod , Lambha Sanjeev Kumar , Verma Rajiv
Published: September 2024

The two aspect ratios 1.0 and 0.5 analysed comparatively to perform a stability study of a 120° partial arc journal bearing have lubricated with a fluid of couple stresses. Reynold’s equation in modified form is obtained for couple stresses and coupled with elasticity equation to predict the impact of deformation in bearing liner on stability characteristics of journal bearing to know its performance. The results quoted here are in terms of attitude angle, somerfeld number, critical mass, whirl frequency and threshold speed. The conclusion made shows that the bearings with high aspect ratio (1.0) are more stable than aspect ratio 0.5 for the fluid of couple stresses and its stability is improved by the use of fluid with couple stresses. Threshold speed is reduced with an increase in the factor of liner deformation and shows that the region of stability is reduced on increasing deformation of bearing liner.
Characterization of Very Thin 3C-SiC Epilayers on Si
Authors: Zielinski Marcin , Bussel Marc , Portail Marc , Michon Adrien , Cordier Yvon
Published: September 2024

We verify experimentally to what extent the intensity of 3C-SiC TO peak in infrared reflectance spectrum can be used to estimate the thickness of extremely thin 3C-SiC epilayers on Si. The influence of several Si substrate characteristics (orientation, doping level, back-side surface preparation) on the peak calibration is discussed.
Aortic dissection presenting with respiratory failure: case report and literature
Authors: Gherardi Simone , Ippolito Renato , Pasqualin Stefano , Cianci Vito , Paganini Matteo
Published: September 2024

Due to its nonspecific symptoms, in several cases, Acute Aortic Dissection (AAD) is a difficult-to-diagnose urgent condition. The torn intimal layer initiates a false lumen, which can potentially propagate and cause life-threatening ruptures or organ ischemia. Intramural hematoma can rarely develop inside the false lumen, resulting in compression of surrounding structures and worsening the patient’s prognosis. We report a case of AAD - Stanford Type A complicated by an intramural hematoma compressing the pulmonary artery, accompanied by a discussion of relevant literature. This patient presented to the emergency department with acute respiratory distress; clinical and initial diagnostic findings mimicked pulmonary embolism. However, a systematic differential evaluation supported by point-of-care ultrasound allowed a prompt diagnosis of AAD and avoided fixation errors.
9: Evaluation of the neck circumference to thyromental distance ratio as a predictor of difficult intubation-A prospective observational study
Authors: S Pradeep , SudeshnaBharKundu
Published: September 2024

Background and Aims:

Preoperative identification of difficult airway and subsequent planning is of utmost importance for patient safety. Previous studies have identified neck circumference to thyromental distance ratio (NC/TMD) as a reliable predictor of difficult intubation in obese patients.[1] But, there is lack of a reported study evaluating NC/TMD in the non-obese patients. The aim of our study was to evaluate the NC/TMD as a predictor of difficult intubation in both obese and non-obese patients.

Methods::

A prospective observational study was conducted after obtaining Institutional Ethics Committee clearance and written informed consent from each patient. Hundred adult patients undergoing elective surgeries under general anaesthesia with orotracheal intubation were included in this study. Difficulty in intubation was assessed using Intubation Difficulty Scale (IDS>5).[2] The NC/TMD was calculated and was compared with other established parameters in predicting difficult intubation in both obese and non-obese patients. Statistical Package for the Social Sciences (SPSS) software (version 22.0) was used for statistical analysis.

Results:

Univariate logistic regression analysis showed that sex, weight, body mass index, inter-incisor gap, Mallampati classification, neck circumference, thyromental distance, sternomental distance and NC/TMD had a significant association with difficult intubation. NC/TMD has a higher sensitivity, specificity, PPV and NPV with a large area under curve (AUC) (P = 0.000) in comparison to other parameters.

Conclusion:

The NC/TMD is a reliable and better predictor of difficult intubation in both obese and non-obese patients in comparison to neck circumference, thyromental distance, sternomental distance alone

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Anaesthetic management of children with a single ventricle with pulmonary atresia coming for emergency burr hole tapping
Authors: Palaniappan Pavithra
Published: September 2024

Background and Aims:

Post-operative atrial fibrillation (POAF) occurs in 30–50% of patients after coronary artery bypass surgery (CABG). Serum hypomagnesemia is common after cardiac surgeries. The primary objective was to evaluate whether magnesium infusion could reduce the incidence of POAF after off-pump CABG.

Methods:

This prospective, single-centre, randomised controlled study was conducted among 100 patients who underwent off-pump CABG. The participants were classified into two groups: group (M), study group, started on magnesium infusion for 3 days after an initial bolus dose as the patient is received in the intensive care unit (ICU), and group (C), control group, managed with usual care. The target in group M was to attain a serum magnesium level of 1.5 to 2 mmol/L. The incidence of POAF was observed in both the groups. A p value < 0.05 was taken as statistically significant.

Results:

The incidence of POAF was significantly higher in the control group (20%) when compared to the study group (2%) (p = 0.008). There were no significant changes in the secondary objectives (vasoactive inotropic scores, length of ICU stay, additional pharmacotherapy, and cardioversion needed) between both the groups.

Conclusion:

The study established that continuous magnesium infusion was effective in preventing POAF in patients undergoing off-pump CABGs.
Evaluation of haemodynamic stability with the fascia iliaca compartment block in the elderly undergoing hip surgeries
Authors: Ruchijain
Published: September 2024

Background and Aims:

Elderly patients with hip fracture have a high anaesthetic risk. Peri-operative management poses a challenge requiring a multi-disciplinary approach. This study investigated whether the fascia iliaca compartment block (FICB) with general anaesthesia (GA) using a supra-glottic device (SGD) can provide adequate analgesia and peri-operative haemodynamic stability and avoid post-operative complications.

Methods:

This prospective observational cross-sectional study was conducted after Institutional Review Board clearance and written informed consent of 30 patients of the American Society of Anesthesiologists grade II and III, undergoing elective surgery for fracture neck femur fracture, were obtained. After pre-medicating patients with inj. Glycopyrrolate and Midazolam, ultra-sonography (USG)-guided FICB was given in the supine position with a high-frequency linear probe using 30 ml of 0.25 % bupivacaine with 8 mg dexamethasone. After confirming the effect of the block at 20 min, patients were given GA with inj. Propofol and proper size I-gel was placed, and patients were maintained on oxygen, nitrous oxide, and sevoflurane.

Results:

FICB with GA using an SGD provides peri-operative haemodynamic stability with minimal changes in mean blood pressure and a heart rate with p value < 0.05. The visual analogue scale (VAS) score before giving the block was 9.5 ± 0.5, which decreased to 2.7 ± 0.49 at 20 min after giving the block, which was statistically significant. The post-operative duration of analgesia was 456 ± 43.438 min.

Conclusion:

Elderly patients with fracture neck femur often have one or more co-morbidities. In such patients, FICB with GA using an SGD is a useful technique providing peri-operative haemodynamic stability and satisfactory post-operative analgesia.
Abstract No. : ABS0233 : Perfusion Index to Predict Hypotension following Subarachnoid Block in Caesarean Delivery
Authors: Varghese Resmy John
Published: September 2024

Background & Aims:

Perfusion index (PI) is a non-invasive monitoring tool. However, there are limited studies on predicting hypotension using PI. The aim of this study was to determine the predictive ability in foreseeing hypotension using baseline P.I in caesarean section following blockade

Methods:

In our prospective observational study, a total of 300 parturients were included. Along with the regular preoperative monitoring, baseline PI was assessed. Subarachnoid block was obtained with 12mg hyperbaric 0.5% bupivacaine and a level of T6 was attained. Haemodynamic variables were monitored every minute for initial 10 minutes and then every 5 minutes during surgery after spinal anaesthesia. Hypotension was defined in the study as more than 20% decrease from the baseline mean arterial pressure.

Results:

Receiver Operating Characteristic (ROC) analysis revealed that baseline perfusion index could predict hypotension following a subarachnoid block in caesarean section. A new cut off point of 3.6 was obtained for PI with 81.2% sensitivity and 90.2% specificity. Area under the curve for baseline perfusion index in detecting hypotension following spinal anaesthesia was 0.906.

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Conclusion:

In our study we made an attempt to find a new predicative cut off value for baseline PI. We were able to illustrate that, a cut off value of PI 3.6 could predict hypotension. ROC analysis depicted fairly good sensitivity and specificity for baseline PI to predict hypotension after subarachnoid blockade in caesarean section
Abstract No.: ABS0322: COMPARISON OF PROPOFOL AND DEXMEDETOMIDINE SEDATION FOR AWAKE C-MAC D-BLADE VIDEO-LARYNGOSCOPIC INTUBATION IN DIFFICULT AIRWAY CASES
Authors: Vishnoi Gunjan
Published: September 2024

Background & Aims:

Safest method for securing difficult airway is awake intubation. Aim is to compare propofol and dexmedetomidine for C-MAC D-blade guided difficult intubation under conscious sedation. A prospective, interventional, two arm, randomised study including 60 American Society of Anesthesiologists (ASA )grade I-III patients.

Methods:

After nasal packing, local anaesthesia, IV midazolam 0.03mg.kg-1and IV fentanyl 1µg.kg-1, in Group-P, propofol was infused at rate of 250 µg.kg.-1min-1, and in Group-D, dexmedetomidine 1 µg g.kg-1 over 10 min, then 0.5 µg .kg.-1h-1, till BIS values 65-70. Patients underwent C-MAC D-blade video-laryngosope guided intubation. Quantitative variables were compared using unpaired t-test/Mann-Whitney Test between groups and paired t-test/Wilcoxon ranked sum test across follow- up within the group. Qualitative variables were correlated using Chi-Square test/Fisher`s exact test. A p-value of <0.05 was considered statistically significant. Data was analysed by Statistical Package for Social Sciences (SPSS) version 24.

Results:

The mean intubation score was higher in the dexmedetomidine group (4.4) [propofol group (3.6)]. Patient reaction to intubation and haemodynamic parameters were more favourable in the propofol group. Coughing and vocal cord movementwas comparable. Time to achieve desired BIS-value was 4 times longer and time to intubate was six seconds longer indexmedetomidine group. Percentage of Glottic Opening (POGO)scores were slightly better in the propofol group. Propofol group was comparatively complication free.

Conclusion:

Successful awake video-laryngoscopic intubation using the C-MAC D-blade can be performed in patients in both groups.Propofol gives a better intubation score and haemodynamic stability than dexmedetomidine.
Abstract No.: ABS0639: A comparison of the total intraoperative fluid administered by goal directed fluid therapy and conventional fluid therapy in isolated traumatic brain injury patients undergoing early decompressive craniectomy- a prospective randomised controlled trial
Authors: Jonna Dhatri
Published: September 2024

Background & Aims:

Traumatic brain injury patients are prone to osmotic and electrolyte disturbances, hence require a unique approach to fluid management. Primary aim of the study is to compare goal-directed therapy and conventional hemodynamic based therapy on total intra-operative fluid administered during decompressive craniectomy

Methods:

Prospective randomised controlled trial was conducted at PGIMER, accruing 64 adult patients with TBI undergoing decompressive craniectomy Goal directed fluid therapy (GDT) used Flo Trac, EV-1000 device (Edwards Lifesciences, Irvine, CA) to monitor Stroke volume variation, Cardiac index and mean arterial pressure Conventional fluid therapyutilisedcrystalloids infused at a rate of 2 ml/kg/hour with target MAP >70 mm of Hg. Quantitative variables were compared using unpaired t test if normally distributed, Mann Whitney U test was used for non-normally distributed quantitative and ordinal data. A P < 0.05 was considered statistically significant. The statistical analysis was done using IBM SPSS version 25.

Results:

There was a numerical difference in total fluid administered between both the groups but did not prove to be statistically significant (p=0.511). No significant difference in intraoperative blood loss (p=0.776), urine output (p=0.230), total ventilator days (p=0.30), total ICU days (p=0.34), total hospital days (p=0.57) and GCS at discharge (0.53). There was significant difference in levels of hematocrit (p=0.00) and levels of lactate (p=0.00) within both the groups and GCS pre- and post-surgery (p=0.04)

Conclusion:

No statistically significant difference between the total intraoperative fluid administered between both the groups was observed. Quest for methods to improve outcome in traumatic brain injury patients it still ongoing.
Abstract No. : ABS1071: Comparison of three different volumes of local anaesthetics in incidence of hemi-diaphragmatic paresis in ultrasound-guided interscalane brachial plexus block -A randomised controlled trial
Authors: G Annushha Gayathri
Published: September 2024

Background and Aims:

The incidence of diaphragmatic palsy following Interscalene brachial plexus block(IBPB) is almost 100% where the drug volume plays an indispensable role. This study compared the incidence of hemi-diaphragmatic paresis and success rate following IBPB using three different volumes of local anaesthetics(LA).

Methods:

Ninety patients undergoing shoulder and arm surgeries under IBPB using ultrasound were randomly allocated into three groups based on volume of LA: Group A(10ml), group B(15ml), and group C(20ml). The drug administered was 0.75% ropivacaine with 50 µg dexmedetomidine under ultrasound guidance. Diaphragm excursion was measured before and 30 minutes after the block on the side of surgery. The incidence of diaphragmatic palsy and its degree were noted. The success rate following block, the onset of sensory blockade, duration of postoperative analgesia and, adverse effects were observed in all three groups.

Results:

The demographic data, duration of surgery and success rate following block were statistically insignificant. Hemi-diaphragmatic paresis (<25%,25-75%,>75%) in group A(29,1,0), group B(17,13,0), and group C(15,8,7) was statistically significant (P-value<0.001)(figure 1). The difference in onset of sensory blockade in group A(7.06±0.73min), group B(6.23±0.72min) and group C(4.61±0.63min) was statistically significant with a P-value<0.001. The duration of postoperative analgesia in group A(440±48.42min) group B(429±44.48min), and group C(411±51.37min), was comparable (Pvalue-0.0719). Five patients in group C developed hoarseness of voice postoperatively which was managed conservatively.

Conclusion:

Lower LA volumes in ultrasound guided interscalene block is associated with lower incidence of hemi-diaphragmatic paresis with a similar success rate and duration of postoperative analgesia. Higher volume of drug yields faster onset of the sensory blockade.

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Abstract No.: ABS1132: A Comparative study of Oropharyngeal leak pressure in LMA ProtectorTM with cuff pilot vs LMA SupremeTM in paralysed patients: A prospective randomised clinical study.
Authors: Macwan Sharmy
Published: September 2024

Background & Aims:

Oropharyngeal leak pressure (OLP) is the pressure at which a gas leaks around the airway, higher leak pressures, betterseal. Our primary aim was to measure OLP and Secondary aims were to measure Insertion Time, Numbers of Attempts,Ease of Insertion, and Postoperative complications.

Methods:

The study was carried out in 62 adult patients of ASA I & II which were randomized into 2 groups Group S (LMA SupremeTM) and Group P (LMA ProtectorTM) (n = 31 each) based on a computerâ€‘generated random sequence table.

Respective LMA’s were inserted after general anaesthesia induction and OLP were measured at cuff pressure of 60 cmH2O in each group accordingly. Secondary Parameters such as insertion time, no of attempts of supraglottic airway devicesand gastric tube, ease of insertion were measured. Intraoperative haemodynamic parameters and postoperatively airwaymorbidity were also measured.

Results:

OLP were significantly higher (P<0.0001) for LMA Protectorâ„¢ compared to LMA Supremeâ„¢.The OLP in LMAProtectorâ„¢ group was 28.12 cmH2O (SD- 1.96) compared to 21.5 cmH2O (SD- 2.65) in LMA Supremeâ„¢ group. Insertiontime was significantly higher for the LMA Protectorâ„¢ (24.58 sec) compared to the LMA Supremeâ„¢ (16.67 sec) (P<0.0001). There were no statistically significant differences in ease of insertion, Numbers of Attempts, trauma, sorethroat, Dysphagia and Dysphonia.

Conclusion:

Oropharyngeal leak pressures were consistently higher (>5 cm H2O) for LMA Protectorâ„¢ compared to LMA Supremeâ„¢, Thus providing effective ventilation than LMA SupremeTM .
Abstract No.: ABS2092: Study of perioperative modified early obstetric warning scores among pregnancy Induced hypertensive patients posted for caesarean deliveries.
Authors: Thomas Mareena
Published: September 2024

Background & Aims:

This study was aimed at identifying the usefulness of Modified Early Obstetric Warning Score (MEOWS) in predicting perioperative maternal outcome in patients with pregnancy induced hypertension (PIH) presenting for caesarean delivery (CD).

Methods:

A prospective observational study was conducted in a tertiary hospital in New Delhi, after approval by the institutional ethics committee. Data was collected using a predesigned proforma just before and 24 hours after CD, based on which the preoperative and postoperative MEOWS were determined. The mean of preoperative and postoperative MEOWS was taken as perioperative MEOWS. Sensitivity, specificity, positive and negative predictive value were derived and ROC analysis was done to find the discriminating power of MEOWS to predict the maternal outcome.

Results:

A total of 106 patients with PIH were analysed. A direct linear relationship was noted between increasing mean perioperative MEOWS and poor maternal outcome. A mean perioperative MEOWS â‰¥ 4.25 predicted maternal morbidity and mortality with a sensitivity of 70%, specificity of 91.86 %, positive predictive value of 66.67%, negative predictive value of 92.94 % and an accuracy of 87.74%.

Conclusion:

Our study suggested that MEOWS is a useful tool for predicting the maternal outcome in parturients with PIH presenting for CD.
Abstract No. : ABS2211
Authors: Raja Thanigai
Published: September 2024

Background & Aims:

Neurolytic celiac plexus block (NCPB) is a promising treatment modality apart from commonly practiced oral analgesic therapy (OAT) for pancreatic cancer pain. This study aimedto compare the efficacy of NCPB with OAT in the treatment of severe pancreatic cancer pain.

Methods:

Forty four patients with severe upper abdominal pain Visual Analogue Scale (VAS) score ≥7/10, due to unresectable pancreatic cancer were allocated randomly and equally in either NCPB group or OAT group. Patients in NCPB group were treated with 99.99% ethanol as a neurolytic agent for celiac plexus block under computerised tomography(CT) guidance. Patients in OAT group were treated with morphine tablets given orally. Patients’ pain intensity (VAS) and opioid analgesic consumption (oral morphine equivalent (OME)) were assessed at day 1, 7 and 28 after the intervention. Oral Morphine tablets were started in the NCPB group when patients developed severe pain after the intervention.

Results:

Mean baseline VAS scores were 8.2 and 7.9 for NCPB group and OAT group, respectively. At day 1, 7 and 28, pain scores of NCPB group were significantly lower than OAT group (P<0.05), 1.4±0.7 versus 3.9±0.8, 1.7±0.6 versus 3.3±0.5 and 2.1±0.8 versus 3.0±0.7, respectively. At day 1, 7 and 28, OME (mg/day) values of NCPB group were significantly lower than OAT group (P<0.05), 8.1±0.2 versus 39.5±0.7, 12.2±0.8 versus 48.3±0.4 and 14.6±0.5 versus 57.1±0.8, respectively.

Conclusion:

CT guided NCPB is an effective treatment modality for controlling severe upper abdominal pain due to unresectable pancreatic cancer.
Abstract No. : ABS2374: Comparison of erector spinae block versus thoracic epidural anaesthesia for postoperative pain management in adult patients undergoing thoracotomy
Authors: Meka SreePooja
Published: September 2024

Background & Aims:

Thoracic epidural analgesia (TEA) was compared with erector spinae block (ESP) for postoperative pain management in patients undergoing thoracotomy.

Methods:

A prospective, randomised clinical study was conducted. 64 patients were enroled and randomised by simple randomsampling into either group A: TEA (n=32) or group B: ESP block (n=32). Both groups received standardised general anaesthesia and continuous infusion of 0.125% bupivacaine plus 2 µg per ml fentanyl at the rate of 5 ml/hour till 48 hours postextubation.The primary outcome was to compare Visual analogue scale (VAS) for postoperative pain. Secondary outcomes included peakinspiratory flow rates, ventilator stay duration, haemodynamic parameters, adverse effects, ICU stay.Statistical analysis was performed using independent Student’s t-test. p value of <0.05 was considered statistically significant.

Results:

Group A had statistically significant higher VAS score than B at 3,6,12,24 h post-extubation. Group B had higher peak inspiratory flow rates compared with group A at 3,6,12,24,36, 48 h respectively. Duration of ICU stay was longer in group A than B. Rescue analgesia usage was higher in group A compared to group B. No adverse effects were reported in both groups.

Conclusion:

ESP block is an efficacious alternative to TEA in providing better postoperative pain management with minimal ICU stay following open thoracic surgeries.

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Abstract No.: ABS2522: Comparison of Age-Based Versus Length-Based Method Using BroselowTape for Estimating Endotracheal Tube Size in Indian Children
Authors: Khasnis Ketki
Published: September 2024

Background & Aims:

Using correct size ETT for paediatric intubation is important for effective ventilation.There is no single formula for estimating accurate size endotracheal tube (ETT) despite various studies. The aim of the present study wasto compare two different methods; age-based andlength-based (using Broselow tape) for estimating accurate size

Methods:

60 patients of either gender between 1”and6years age, undergoing elective surgery under general anaesthesia requiring endotracheal intubation with uncuffed endotracheal tube(ETT) were enroled in this study. ETT size was selected by senior anaesthesiologist as per their discretion. The ETT used was deemed to be a correct fit based on minimal air leak with peakinspiratory pressure 15cmof H2O, expired tidal volume>7 ml/kg, bilateral equal breath sounds, square wave capnograph, ETTpassing smoothly through the glottis and respiratory rate according to child’s age. The actual ETT used was compared with that predicted by age and length of the child (using Broselow tape).

Results:

Each method was tested for accuracy at predicting clinically accepted ETT size by subtracting ETT size used for each patient from size predicted by each method. Our study revealed that Broselow tape has overall correct predictability rate of 53.3% whereas age based formula has 46.6%. The ETT used was found to correlate with length (p=0.004, p<0.005 being significant).

Conclusion:

Length of child has good correlation with size of ETT to be used in Indian children. Broselow tape is an effective tool to predict ETT size and is a simple,accurate aid especially where age and weight are unknown.
Abstract No.: ABS2724: Correlation of peri-operative factors with immediate graft functions in renal transplant patients
Authors: Paighan Kalyani
Published: September 2024

Background and Aims:

The number of successful transplants has increased dramatically. Very few studies have demonstrated the effect of various peri-operative factors on the immediate graft function (IGF) after transplant. This study aimed at evaluating the various peri-operative factors affecting the IGF.

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Methods:

This was a prospective observational study performed in patients undergoing renal transplant from 2018 to 2019. The recipient population was divided into two groups: group A, live donor recipients (LD), and group B, deceased donor recipients (DD). Pre-operative parameters such as patient demographics, co-morbidities, investigations, vitals, duration of dialysis, site, and frequency were noted. Patients were induced routinely. Intra-operative factors such as vitals, episode of hypotension, need for inotropes, ischemia time, and urine output were noted. The graft outcome variables such as 24-hour urine output, creatinine, blood urea nitrogen, need for dialysis, haemoglobin and creatinine upto 6 months, need for intravenous immunoglobulin, and plasma exchange were noted.

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Results:

There was a significant difference in cold ischemia time (p = 0.000), immediate urine output (p = 0.016), post-operative values of haemoglobin (p = 0.03), potassium (p = 0.001), creatinine (p = 0.000), and creatinine at 1 month post transplant (p = 0.03) among both the groups. Factors such as pre-operative urea and haemoglobin affect 24 hour urine output in the DD group, whereas pre-operative urea, systolic blood pressure (SBP), and diastolic blood pressure (DBP) and post-operative SBP, DBP, potassium, and creatinine affect 24 hour urine output in the LD group.

Conclusion:

Decreasing the cold ischemia time even in deceased donor kidneys will improve the renal function in terms of urine output, electrolytes, and creatinine.
Abstract No. : ABS2758: To assess the effect of Dexmedetomidinenebulisation on propofol requirement for induction in laparoscopic tubal ligation- Patient State Index (PSI) guided general anaesthesia
Authors: K Shruthi
Published: September 2024

Background &Aims:

Laparoscopic tubal ligation is one of the most commonly performed sterilization procedure on a day care basis. This study aims to assess the effectiveness of dexmedetomidinenebulisation on propofol requirement for induction.

Methods:

After obtaining ethical committee clearance, A randomiseddouble blind clinical trial was performed on 40 parturients of AmericanSocietyofAnesthesiologists physical status I and II. Theywere posted for laparoscopic tubal ligation under general anaesthesia with spontaneous ventilation using I gel. They were divided into 2 groups. Group D received dexmedetomidinenebulisation 2µg/kg 20min before induction, Group P received saline nebulisation ,both groups were induced with injection propofol to maintainPatient State Index(PSI) in the range of (25-50). Consumption of propofol, heart rate , systolic blood pressure,diastolic blood pressure, mean arterial blood pressure and any incidence of adverse events were noted.

Results:

The demographic variables were comparable between the two groups. There was significant difference between the mean propofol dose for induction in group D and group P i.e 55.50+/-7.23 and 89+/- 6.40 respectively, with p <0.001 using Mann Whitney U test. Postoperatively, parturients were assessed with Ramsay sedation scale which was statistically not significant.

Conclusion:

Preoperative nebulisation with dexmedetomidine significantly reduces the induction dose of propofol.
Abstract No.: ABS3313: Current scenario: Knowledge of compression only life support among non-medical staff
Authors: Kerketta Carolin Smita
Published: September 2024

Background and Aims:

This study intended to analyse the effectiveness of compression only life support–cardiopulmonary resuscitation (COLS–CPR) training based on knowledge acquired among non-medical staff. A Google questionnaire form was used as an interventional tool.

Methods:

The study was conducted among 300 non-medical staff. Study design: It was an interventional study where the effect of COLS–CPR training was evaluated based on the pre-training and post-training assessment score. Study participants: Security guards, ambulance drivers, and the house-keeping facility of our hospital were included in the study. Intervention: Training was conducted for 7 days through lecture, audio-visual display, and demonstration, and then, hands on session was conducted at the end of each training. The Google form questionnaire consisted of COLS meaning, rate, depth of compression, usefulness, etc.

Results:

The analysis of the questionnaire among 300 non-medical staffs was performed by IBPM software version 20 with the paired t-test. For the pre-test, questions 1, 2, 3, 4, 5, and 6, the correct answers were 82%, 20%, 15%, 5%, >80%, and <10%, respectively. In the post-test, the correct answers for post-test questions 1, 2, 3, 4, 5, and 6 were 100%, 100%, 100%, 67%, 100%, and 99.3%, respectively. A p value of <0.01 suggested that training was highly effective and made a statistically significant difference in knowledge of the participants.

Conclusion:

Among non-medical staff, this study emphasises the cognitive approach to the general perception and skill of COLS. Hence, formal refresher training and experience enhance the knowledge of CPR, which can save many lives!

COLS Google form questionnaire.

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