bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Dexmedetomidine, midazolam and propofol for sedation of post operative patients on mechanical ventilation- An open label randomised control trial
Authors: Paul Surajit , Majumdar Vaskar 
Published: October 2021

Mechanical ventilation is a life-sustaining therapy for the treatment of patients with acute respiratory failure. One of the key factors for good clinical practice in the ICU is to provide adequate sedation. An ideal sedative should provide a rapid onset, a rapid recovery. On this background the present study is designed to evaluate the efficacy and safety of dexmedetomidine, propofol and midazolam for sedating property, hemodynamic effects and analgesic. It is an open label, single blinded randomized control trial. Census sampling is planned for recruitment which will have maximum power and type I error &#60;0.05.This study is carried out in 39 adult patients with Glasgow coma scale score of 9-15, Patients were divided randomly into three groups of 13 each. Group M patients received IV inj. Midazolam loading dose 0.15mg/kg followed by maintenance dose of 0.02-0.1mg/kg/hour. Group P patients received intravenous inj. Propofol loading dose of 1.5mg/kg followed by continuous infusion of 1-6 mg/kg/hr. Group D patients received intravenous inj. Dexmedetomidine loading dose of 1μg/kg followed by maintenance dose of 0.2-0.5 μg/kg/hr of continuous infusion by infusion pump. Desired depth of sedation was assessed by Ramsay Sedation Score. The difference in mean age and ASA status among the three groups are not statistically significant. There is no statistical significance of sex & GCS status of the patients of these three groups. In our study, difference of mean HR at different time interval was not statistically significant. But the fall in Heart Rate is more in Group D and Group M than in Group P. The mean heart rate is less in Group D compared to Group M and Group P after 45 minutes of infusion. We found that difference of mean SBP & DBP at different time interval was not statistically significant. In overall Dexmedetomidine Group showed stable RSS score throughout the time interval (between RSS 2 to 3). One patient in Dexmedetomidine group developed bradycardia. Mean opioid at 24th hour was significantly higher in group M than other group and difference was statistically significant and post sedation delirium was not statistically significant. In this study we found that difference of mean hemodynamic parameters at different time interval in three drugs was not statistically significant. The Heart Rate remain lower in Dexmedetomidine Group compared to Midazolam and Propofol Group after 45 minutes of infusion.
Comparison of Dexmedetomidine with Fentanyl and Pentazocine – Promethazine in patients undergoing dilation and curettage in monitored anesthesia care
Authors: Aggarwal Akanksha , Mahajan Divya 
Published: October 2021

Dilatation and curettage (D and C) is an essential and common minor surgery in obstetrics and gynecology. Sedation, hypnosis and analgesia are used in combination for such short procedures. These days conscious sedation is provided to patients for day care surgeries which includes analgesia, sedation and anxiolysis while rapid recovery is ensured without side effects. Dexmedetomidine is a highly selective alpha-2 agonist that provides anxiolysis and conscious sedation without respiratory depression. It was to study the effect of dexemedetomidine with fentanyl versus Pentazocine with promethazine on hemodynamic stability and recovery during sedation in dilatation and curettage procedure. The comparison included the hemodynamic data and recovery time. The effect of the drugs on hemodynamics and monitoring the occurrence of any complication were also done. In our study, 50 patients were randomly divided into 2 equal groups; group DF received dexmedetomidine loading dose 1 μg/kg over 10 min and followed by 0.5 μg/kg/hr infusion till completion of surgery and group PP received pentazocine 0.5 mg/kg (max 30mg) and Promethazine 12.5 mg slow intravenous Bolus. Dexmedetomidine is a safe drug which provides good hemodynamics and less recovery time. It also exerts sedative and analgesic effects without respiratory depression unlike most analgesic/sedative drugs, such as ketamine, pentazocine and benzodiazepines. This study demonstrates that dexmedetomidine is a safe drug with good hemodynamic and recovery profile. Dexmedetomidine administration showed better preservation of MAP and SpO2.
Six minute walk test for predicting postoperative pulmonary complications in high risk patients undergoing major abdominal elective surgery
Authors: Prajapati Payal P , Mehta Pancham H , Aghara Aniket , Mehta Kamla H 
Published: October 2021

The morbidity and mortality of patients are increased when postoperative pulmonary complications occurs. To prevent postoperative pulmonary complications, thorough preoperative cardiopulmonary functional assessment is required.To study was the preoperative 6-minute walk test (6MWT) and to determine the association of 6 minute walk distance with postoperative pulmonary complications (PPC) in patients undergoing elective abdominal surgery under general anaesthesia. The study was done in 60 adult high risk patients who were undergoing planned elective abdominal surgery under general anaesthesia. Patients having acute coronary disease, NYHA IV, unable to walk etc. were excluded. Preoperatively 6MWT was conducted according to the American Thoracic Society guidelines and patients were observed for PPC until they discharged from the hospital or died. Statistical analysis was done using SPSS software A total of 60 patients were recruited into the study. 6MWT was done completely in all cases without any complications. Out of the 60 patients, 32 patients had no PPC (group 1) and 28 patients had PPC (group 2). The 6MWD of group with PPCs was significantly less (344 ± 61.927 m) compared to the group without PPCs (442.28 ± 83.194 m, P value = 0.001). The cut off 6MWD obtained was 390 m, which correlated with longer duration of hospital stay and ICU stay (P = 0.001).A multiple regression analysis showed elderly, smoker and shorter 6-minute walk distance (6MWD) were the independent factors associated with PPC. 6MWT is a reliable predictor of postoperative pulmonary complications with a cutoff 6MWD of 390m in the high risk elderly patients posted for upper abdominal surgery patients.
To compare the hemodynamic effects of the infusion of both intravenous induction anaesthetic agents Etomidate and Propofol under bispectral index guidance
Authors: Chauhan Renu , Lalchandani Kavita , Upadhyay M R 
Published: October 2021

Intravenous anaesthetic agents are preferred to induce anaesthesia in day to day practice because of rapid and smoother action with fewer risks. An ideal induction agent for general anaesthesia should have hemodynamic stability, minimal respiratory side effects and rapid clearance. This is a prospective, randomised, single blind, control study of total 60 patients.This study was carried out in Department of Anaesthesiology, at a Tertiary Care Teaching Hospital over a period of 1 year. In this study, a total of 60 patients undergoing elective surgery under general anaesthesia were randomized into two groups comprising of 30 patients in each group using envelop method. Group A- Patients received Inj. Etomidate infusion at the rate of 0.05 mg/kg/min through syringe infusion pump, and Group B – Patients received Inj. Propofol infusion at the rate of 0.5 mg/kg/min through syringe infusion pump.The hemodynamic response during induction of general Anaesthesia using Inj. Etomidate and Inj. Propofol under BIS guidance. There was no statistically significant difference observed in mean time taken for induction in both the groups. Mean consumed dose for Etomidate was 0.18+0.05 mg/kg and for Propofol group was 1.82+0.34 mg/kg. There was statistically significant fall in mean arterial blood pressure observed in Group B compared to Group A during and after induction up to 7 minutes. After that there was no significant difference observed in both the groups.: Propofol resulted in hypotension and bradycardia even with the reduced doses given with BIS- guided protocol. However, Etomidate provides more hemodynamic stability during induction and in post induction period also. So, Etomidate can be a better choice of agent for induction of General Anaesthesia as compared to Propofol.
To assess knowledge and awareness of basic life support among final year medical students in tertiary care teaching centre: A cross sectional study
Authors: Sahithya K , Uma G , Manoj M Murali 
Published: October 2021

Successfulcardiopulmonary resuscitation (CPR) relies upon the information and aptitudes of basic life support (BLS). Knowledge of basic life support is needed for budding medical students as they will encounter such situation on a daily basis. The study aimed to evaluate the knowledge of basic life support (BLS) among undergraduate final year students.A descriptive, cross-sectional study was led in a tertiary care medical college from July 2019 to August 2019. The study participants were final year MBBS students. 100 final year students were given questionnaire about basic life support according to the guidelines laid down by the American Heart Association Guidelines for BLS. The outcome variables knowledge and awareness were analysed in terms of frequencies and percentages. (yes/no). IBM SPSS version 22 was used for statistical analysis.Self-grading of BLS knowledge level was assessed and the results showed that 62(62%) had average knowledge and 38(38%) had poor knowledge. In Self-assessment question, the reason for lack of BLS knowledge was, 7(7%) due to busy curriculum, 7(7%) lack of interest, 65(65%) non-availability of training and 21(21%) responded as combination of all three factors. Awareness and knowledge about basic life support (BLS) is certainly required for medical care experts as they experience such circumstance consistently, and will help them a long way in saving lives. Proper training and workshops are mandatory on BLS/CPR in our undergraduate medical curriculum.
Comparing the efficacy of tramadol, ketamine and dexmedetomidine in the prevention of intraoperative shivering in patients undergoing surgery under subarachnoid blockade
Authors: Kumar R Arun , Ammu S 
Published: October 2021

The most common nagging and inconveniencing complication of spinal anesthesia is intra operative shivering. Central neuraxial blockade blunts the thermoregulatory mechanism by restricting vasoconstriction, resulting in shifting of central heat to the periphery from the trunk. Various pharmacological and non pharmacological methods are used for the control of intraoperative shivering.The aim of our study was to compare the efficacy of Tramadol, Ketamine and Dexmedetomidine in the prevention of intra operative shivering in patients undergoing surgeries under subarachnoid blockade.90 patients of age group between 20 to 65 years belonging to ASA 1 and 2 posted for elective surgery under spinal anaesthesia will participate in this study. The patients were randomly allocated into 3 groups of 30 each and were named as by computer generated random table number. Group T received Tramadol 0.5 mg/kg in 100 ml NS over 10 – 15 minsGroup K Ketamine 0.25 mg/kg in 100 ml NS over 10 – 15 mins and Group D Dexmedetomidine 0.5 μg/kg in 100 ml NS over 10 – 15 mins.Data were statistically analysed with the SPSS version 22.0 software using two-sided unpaired t-test and Chi-square test. A repeated measure of ANOVA was applied for the three groups to know the with-in subject variability in prevention of shivering following subarachnoid blockade and p value &#60; 0.05 was considered to be significant.The conclusion of our study is that Dexmedetomidine at the dose of 0.5 μg/kg decreases effectively in the prevention of intra operative shivering in patients undergoing surgery under subarachnoid blockade when compared with Tramadol and Ketamine.
Norepinephrine versus phenylephrine for maintenance of blood pressure during spinal anaesthesia for caesarean delivery - A randomized double blind controlled study
Authors: Desai Devyani , Kalarthi Bhoomika 
Published: October 2021

: Currently phenylephrine is a preferred 1 line vasopressor for maintenance of blood pressure during spinal anaesthesia, may be associated with reflex bradycardia and decreased cardiac output, posing risk to mother or foetus. Norepinephrine may be an useful alternative as being potent alpha with weak beta adrenergic agonist activity. : This study compared the effectiveness of prophylactic and treatment boluses of norepinephrine and phenylephrine to maintain systolic blood pressure at or above 80% of baseline value during spinal anesthesia for cesarean delivery with the primary aim to compare cardiac output. Secondary aims were total doses of study drug required, neonatal outcome and perioperative complications.: Total 100, term pregnant women with ASA status II undergoing caesarean delivery under spinal anaesthesia were enrolled in this prospective, double blind controlled study. Patients were randomized to receive prophylactic bolus dose of norepinephrine (6 µg) or phenylephrine (100 µg) immediately after spinal anaesthesia. Systolic blood pressure, cardiac output and heart rate were monitored. Intermittent bolus doses were repeated whenever required. Student ‘t’ test and chi square test were used for analysing the data. : Both the drugs were able to maintain the systolic blood pressure ≥ 80% of baseline (p=0.356). Significant difference observed in cardiac output while comparing both the groups from 3 to 15 minutes after spinal anesthesia (p=0.014). The incidence of bradycardia was lower in norepinephrine group as compared to phenylephrine group (P=0.018). : Norepinephrine is as effective as phenylephrine for maintenance of blood pressure after spinal anaesthesia for caesarean delivery with stable heart rate and cardiac output.
A comparative study on the perfomance between I-gel® and Classic laryngeal mask airway in anaesthetized spontaneously breathing patients
Authors: Jacob Leno Ninan , Mathew Jaimy 
Published: October 2021

The classic Laryngeal Mask Airway (c-LMA) is a first generation supraglottic airway device with an inflatable cuff forming a low pressure seal around the laryngeal inlet and permitting ventilation. I-gel is a supraglottic airway device made of thermoplastic elastomer which is soft gel-like and transparent. Unlike the classic LMA(c-LMA), I-gel does not have an inflatable cuff. In view of this, the present study was undertaken to compare the performance of the two supraglottic airway devices in spontaneously breathing adult patients posted for elective surgeries under general anesthesia.To compare the ease of insertion, number of insertion attempts, time for insertion, airway leak pressure, hemodynamic changes as well as perioperative complications such as cough sore throat between patients using the two devices.Sixty patients admitted in SRM medical college and research center scheduled for various elective surgical procedures under general anesthesia belonging to ASA class I and II were included in the study. They were randomly divided into two groups of 30 each using a random number generator. In group I, I-gel supraglottic airway device was used and in Group 2 classic laryngeal mask airway was used. Data was collected using a questionair containing socio-demographic details, details regarding performance of the device as well as hemodynamic changes and perioperative complications.The insertion was easy in 25 patients (83.3%) in group I, while in group II 15 patients (50%) had easy insertion. P=0.0 1781. The mean time of insertion for I-gel was (20. 17± 3 .91 seconds) which was significantly shorter compared to c-LMA (26.80 ±7.24 seconds) (P&#60;0.001).There was no statistically significant difference between the devices with respect to number of attempts of insertion. Even though the airway leak pressure is not statically significant, the mean oropharyngeal leak pressure for I-gel was 20.40±5.68 (mm Hg), which was higher than c-LMA 18.73±5.06 (mm Hg), which is well within the normal limits to prevent aspiration. There were no statistically significant differences in hemodynamic changes. No Blood staining was seen after removal of device in I-gel group where it was observed in 2 (7%) patients in c- LMA group. Post removal cough was more in c -LMA (13 .3%) than l-gel (P= 0.04 SS*). Pharyngo-Laryngeal morbidity was more with classic LMA. Sore throat was more with the classic LMA (13 .3%) when compared to I-gel group (3%).We conclude that I-gel is a better airway when compared to c-LMA with respect to ease of insertion, shorter duration for insertion, adequate oropharyngeal seal with lesser pharyngo-laryngeal morbidity and less incidence of airway trauma.
Neonatal Dhatura like poisoning - A premedication error in neonatal anesthesia
Authors: Tyagi Nirupama , Bisht S S , Saini Anil , Tyagi Amita , Agarwal Anand , Gupta Lalit 
Published: October 2021

Overdosing of drugs sometimes produce fatal consequences. We report such a case of premedication dosing error in neonates with Glycopyrrolate leading to central anticholinergic syndrome (CAS) as in Dhatura poisoning. Accidental overdosing with glycopyrrolate resulted in symptoms like tachycardia, tachypnea, shock, hyperpyrexia, irritability and excessive crying. These symptoms resolved with symptomatic treatment. Errors can occur at any step of the path from drug prescription to administration. Medication errors are common and it should be immediately suspected in neonates with abnormal symptoms after injecting some drug, so that early diagnosis and treatment can be started timely. Identifying such medication errors is a challenge in neonatal care and should be a priority among caregivers in order to prevent future incidents and for patients’ safety.
Assessment and patients perception of the impact of accreditation on the quality of public healthcare delivery in primary and secondary healthcare settings
Authors: P Mathew Sherry , Sunil Vishnu 
Published: October 2021

Accreditation is a crucial component that stresses patient safety and service quality. The goal of this study was to fill in the gaps by evaluating the impact of accreditation in primary and secondary public health care settings. A survey questionnaire was used to perform this cross-sectional study from July 2017 to July 2018. The study used a positivist paradigm, examining quantitative indicators before and after the certification procedure to determine the influence of accreditation.Due to the fact that the data were not normally distributed, the variables were measured on an ordinal scale, the observations from both groups were independent of one another, and the distribution of the variable was similar in each group, the Kruskal– Wallis test was used to determine statistical significance. The mean score for components spanning structural, procedural, and outcome domains has been calculated for certified and non-accredited hospitals. Certified hospitals have higher median values for all structures in primary health-care facilities than non-accredited hospitals. Most of the constructs have a lower or equal median value in accredited secondary care facilities than in non-accredited facilities. Accreditation has the potential to have a positive impact on the entire facility. Nonetheless, authorities must see accreditation as a way of holistic and continual reform if they are to ensure the intended outcome from this lengthy and costly procedure.
Pengembangan Kerjasama Profesional Program Bimbingan dan Konseling
Authors: Mufrihah Arina , Rusmiyati  , Nur Erlinasari  
Published: October 2021

Aims of this descriptive qualitative research are organizing cooperational models of guidance and counseling and analizing use of those professional cooperation activities between counselor and other professionals for students as targeting subject of guidance and counseling service. Author got the needed data from observation method, interview method, and documentation method, while subject of this research are guidance and counseling teachers and students. Guidance and counseling teachers have created some cooperational patterns with motivator, psychology institution, college, and alumna. By these cooperational programs, students acknowledged that they got many supports in understanding and developing their potentials, coping their obstacles, and programming their individual planning.
Penelitian ini merupakan penelitian deskriptif kualitatif dengan tujuan mengorganisasikan pola-pola kerjasama bimbingan dan konseling dan menelaah manfaat yang diperoleh siswa sebagai subjek sasaran layanan BK dari kegiatan kerjasama profesional antara konselor dengan pihak-pihak profesional lainnya. Data penulis peroleh dari observasi, wawwancara, dan dokumentasi, subjek dalam penelitian ini adalah Guru BK dan siswa. Penulis memperoleh hasil penelitian berupa pola kerjasama yang dijalin oleh tenaga BK ialah dengan: (1) motivator; (2) lembaga psikologi; (3) perguruan tinggi; dan (4) alumni. Dengan program kerjasama tersebut siswa mengakui banyak terbantu dalam memahami-mengembangkan potensinya, mengatasi hambatannya, dan melakukan perencanaan individual.
TERAPI MEWARNAI SOLUSI UNTUK MENGURANGI STRES AKADEMIK MAHASISWA TERHADAP KULIAH ONLINE
Authors: Aisa Anna 
Published: October 2021

Salah satu kebijakan pemerintah Indonesia untuk memutus mata rantai penularan virus covid 19 adalah pembatasan sosial atau lebih dikenal dengan psysical distancing. Pemerintah membatasi kegiatan-kegiatan yang tidak terlalu penting. Semua kegiatan sementara waktu dilakukan di rumah, termasuk perkuliahan. Kegiatan perkuliahan yang semula secara tatap muka harus beralih menjadi kuliah online. Pola perubahan pendekatan perkuliahan ini memicu munculnya stres akademik pada mahasiswa. stres akademik yang tinggi dapat menyebabkan gangguan proses berpikir, persepsi dan kemampuan memecahkan masalah serta gangguan tidur dan berkurangnya kekuatan pengambilan keputusan. Jika dibiarkan, akan mengganggu kualitas hidup mahasiswa. Oleh karena itu, diperlukan adanya kegiatan lain untuk mengisi waktu luang dan mengurangi stres akademik mahasiswa. Salah satunya dengan terapi seni dengan metode mewarnai. Kegiatan ini dinilai mampu menurunkan tingkat stres akademik. Metode yang digunakan adalah deskriptif. Data dikumpulkan melalui wawancara terhadap subjek dan dianalisis dengan metode eksplikasi data. Subjek berjumlah lima orang yang diperoleh dengan dengan cara purposif. Hasil penelitian menunjukkan bahwa kelima subjek mengalami penurunan tingkat stres akademik setelah melaksanakan aktivitas terapi mewarnai. Tampak pada semangat dan usaha kelima subjek untuk kembali aktif mengikuti perkuliahan online, semangat mengerjakan tugas yang diberikan dosen dan semangat untuk bertanya serta mencari tahu secara mandiri mengenai informasi seputar materi maupun informasi perkulihan yang belum dipahami.