Asian Journal of Medical Sciences最新文献

{"title":"Assessing the efficacy of anticoagulation therapy in the management of atrial fibrillation: An observational study","authors":"Swathi G, Yerakala Ramesh, Pragna S","doi":"10.3126/ajms.v15i7.66134","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.66134","url":null,"abstract":"Background: Atrial fibrillation (AF) substantially elevates stroke risk. Managing AF with anticoagulation therapy is crucial to reduce this risk, yet assessing the balance between its efficacy in preventing strokes and the potential for bleeding complications is essential.\u0000Aims and Objectives: The aim of this study is to evaluate the efficacy and safety of anticoagulation therapy in the management of AF.\u0000Materials and Methods: This observational study followed 100 AF patients at a government general hospital over 8 months to evaluate the efficacy and safety of anticoagulation therapy. We analyzed stroke occurrence, bleeding complications, treatment adherence, patient satisfaction, and improvements in quality of life (QoL). In addition, we recorded patient demographics and baseline characteristics, such as body mass index, smoking status, and CHA2DS2-VASc scores.\u0000Results: The study population was at a moderate-to-high risk of stroke, with an average CHA2DS2-VASc score of 2.9. The efficacy of stroke prevention was confirmed, with a 2% incidence of stroke events. Bleeding complications included major bleeding in 4% of the patients, with minor bleeding predominantly occurring in the first 3 months of therapy. Treatment adherence was noteworthy, with 75% of patients not missing any doses. High levels of patient satisfaction were observed, with 90% of participants reporting being satisfied or very satisfied with their treatment. QoL, measured through the AF-QoL questionnaire, showed significant improvement from a baseline score of 58–76.\u0000Conclusion: Anticoagulation therapy in AF patients was effective in stroke prevention with a manageable risk of bleeding. High treatment adherence and patient satisfaction further support the therapeutic value of anticoagulation in AF management.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141693568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of efficacy of intravenous dexmedetomidine with perineural dexmedetomidine as adjuvant to ropivacaine in supraclavicular brachial plexus block in upper limb surgery","authors":"Nabanita Roy, Md. Babrak Manuar, Moumita Roy, Bimal Kumar Hajra","doi":"10.3126/ajms.v15i7.43930","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.43930","url":null,"abstract":"Background: In supraclavicular brachial plexus block, to prolong the duration of analgesia, many adjuvants have been tried in the past in many studies but an ideal adjuvant remains yet to be discovered. Dexmedetomidine, a selective Alfa-2 adrenergic agonist when added to local anesthetic has been reported to prolong the block duration and post-operative analgesia in various regional blocks.\u0000Aims and Objectives: The aims and objectives are to study the onset and duration of sensory and motor blockade, postoperative analgesia, and hemodynamic effects of addition of dexmedetomidine with ropivacaine in supraclavicular brachial plexus block.\u0000Materials and Methods: Sixty patients aged between 18 and 60 years, American Society of Anesthesiologists class I and II, of both sexes, scheduled for upper limb surgery under supraclavicular brachial plexus block were randomly allocated into 2 groups. Group-A received 20 mL of 0.5% ropivacaine in brachial plexus block with 1 μg/kg dexmedetomidine as adjuvant perineurally and Group-B received 20 mL 0.5% ropivacaine in brachial plexus block with dexmedetomidine intravenous infusion at 1 μg/kg over 10 min. Intraoperatively non-invasive blood pressure, heart rate, SpO2, and sedation were recorded every 5 min for the first 10 min and every 15 min thereafter till the end. Time of first rescue analgesic, intensity of postoperative pain, and total analgesic required were recorded.\u0000Results: Onset of sensory and motor block was faster in Group-A than Group-B. Duration of analgesia was prolonged in Group-A than Group-B. Hemodynamic stability was better maintained in Group-A than Group-B. Sedation was better in Group B.\u0000Conclusion: Dexmedetomidine as adjuvant to ropivacaine in supraclavicular brachial plexus block is more efficacious in providing faster onset of motor and sensory blocks and prolonging duration of postoperative analgesia with better hemodynamic stability.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141688864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and effectiveness of ultrasound-guided single injection of 5% dextrose for median nerve hydrodissection in carpal tunnel syndrome","authors":"Nitya Jha, Chandan Kumar Jha","doi":"10.3126/ajms.v15i7.65629","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.65629","url":null,"abstract":"Background: In carpal tunnel syndrome (CTS), conservative management did not show satisfactory results, and some patients required revision surgery due to persistent or recurrent symptoms. Ultrasound (USG)-guided median nerve (MN) hydrodissection with a 5% dextrose injection is an advanced approach for treating symptoms of CTS. We prospectively investigated the patients to demonstrate the safety and effectiveness of this approach.\u0000Aims and Objectives: This study aims to evaluate the effect of USG-guided nerve hydrodissection using single injection of 5% dextrose on pain, MN conduction parameters, and functional status in patients with CTS of mild–to-moderate grade. The study also predicts about the safety of the procedure.\u0000Materials and Methods: A study was performed in the pain clinic of the tertiary care teaching institute of India for one year. The study included 15 patients diagnosed with mild-to-moderate CTS. The diagnosis was done on the basis of history, physical examination, and a nerve conduction velocity (NCV) study. Patients were given analgesics and NSAIDS and enrolled in the procedure. Parameters used for statistical analysis were Visual Analog Scale (VAS) scores, NCV study data (sensory conduction velocity [SNCV] and distal motor latency [DML]), and Boston carpal tunnel questionnaire (BCTQ) scores. Pre-injection parameters were compared with parameters 3 months after the injection to show the usefulness of this procedure.\u0000Results: A statistically significant reduction in VAS score was found in 74% of the cases (P<0.05). The nerve conduction study parameters have shown significantly higher SNCV and lower DML latency in 60% of cases (P=0.001 and P=0.001, respectively). Improved BCTQ scores were found in 80% of cases (for the symptom severity scale, P=0.001 and for the functional status scale, P<0.01). No complications such as allergic reactions, sensory loss, or paresis were recorded post-injection. However, transient injection site pain was present in all patients which did not last for more than 24 h.\u0000Conclusion: MN hydrodissection using a single injection of 5% dextrose under USG is a safe and effective approach offering pain relief, better MN conduction, and improved functional status in patients with CTS of mild-to-moderate grade.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141707423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the effectiveness and safety of empagliflozin versus liraglutide in managing diabetic dyslipidemia: An observational study","authors":"Motakatla Usha, Chitra Karuppiah, P. Nagamani, Dr. Penupothu Sree, Associate Professor Nagamani","doi":"10.3126/ajms.v15i7.65428","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.65428","url":null,"abstract":"Background: Diabetic dyslipidemia poses a significant risk factor for cardiovascular complications in patients with diabetes mellitus. Empagliflozin and liraglutide are two commonly used medications in diabetes management, yet their comparative efficacy and safety in treating diabetic dyslipidemia remain under-explored.\u0000Aims and Objectives: This study aimed to assess the effectiveness and safety of Empagliflozin versus liraglutide in managing diabetic dyslipidemia.\u0000Materials and Methods: The study enrolled 100 participants with diabetes and dyslipidemia, divided equally into empagliflozin and liraglutide treatment groups. Baseline characteristics, including age, gender distribution, ethnicity, and duration of diabetes, were assessed and compared between the groups. Lipid profiles, encompassing total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides, were evaluated at baseline and after 6 months of treatment. Safety outcomes, such as the occurrence of mild gastrointestinal symptoms, hypoglycemia, and serious adverse events, were also monitored.\u0000Results: Both treatment groups exhibited comparable baseline characteristics. Following 6 months of treatment, both empagliflozin and liraglutide demonstrated significant improvements in lipid profiles. Reductions in total cholesterol, LDL cholesterol, and triglycerides, along with increases in HDL cholesterol, were observed in both groups. Moreover, there were no significant differences in the occurrence of adverse events between the two treatment groups, indicating similar safety profiles.\u0000Conclusion: This study provides evidence supporting the effectiveness and safety of empagliflozin and liraglutide in managing diabetic dyslipidemia. These findings highlight the potential of both medications as viable therapeutic options for patients with diabetes and dyslipidemia.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paternal influence on pregnancy: Setting the precedence","authors":"Ruby Dhar, Arun Kumar, Subhradip Karmakar","doi":"10.3126/ajms.v15i7.66198","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.66198","url":null,"abstract":"According to sociologist, Sylvia patriarchy is “a system of social structures and practices in which men dominate, oppress, and exploit women.” Derived from the Greek word patriarkhēs, patriarchy means “the rule of the father.” American sociologist Allan Johnson further mentions that patriarchy is a kind of society in which even though men and women participate, but is male-privileged, maledominated, male-identified, and male-centered. Apart from the sociologist’s point of view of society, it seems that developmental programs in biology also have a patriarchal trend. At least, that’s what is reported from several studies recently. Lopez-Tello et al., reported a paternal insulinlike growth factor 2 (Igf2)-related selective trafficking of maternal resources toward the fetus for its development. Metabolic demands for the fetus are enhanced during pregnancy. It is, therefore, observed that there is a relatively greater shunting of metabolic fuels toward the fetus to increase nutrient availability, more than it is perhaps allowed by the maternal system. The placenta assists in this shuttle by promoting insulin resistance, which leads to glucose intolerance in the mother. This glucose is now made available to the fetal compartments. The paternal Igf2 gene undergoes genomic imprinting, and only the copy inherited from the father is active. Paternally active Igf2 expressed in placental endocrine cells directs the maternal lipids and carbohydrates toward the fetus, an excellent example of paternal manipulation of maternal physiology and metabolic patriarchy. Further, studies have shown that fathers fed with a high-fat diet reduce the pregnancy success rate because of the reduction of their sperm motility. Excess intake of processed food, highsugar diets, or fructose has consequences on offspring’s cardiovascular and metabolic diseases. Males fed a low protein diet in mice results in glucose intolerance, metabolic and cardiovascular dysfunctions, and altered patterns of bone mineralization in pups.\u0000We, therefore, can conclude a robust paternal influence on pregnancy and fetal outcome. Pregnancy was once thought of as an exclusively maternal affair. Increasing research in this arena seems to have smashed that stereotype with paternal influence seems to play a significant role in shaping the birth process. It is high time that Sylvia patriarchal understanding is redefined with the paternal share of responsibility beyond just dominance and an authoritarian role.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141693498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical variations and clinical significance of the pyramidalis muscle: A detailed morphometric analysis in cadaveric population","authors":"Pratyusha Challa, Ranzeetha D, Pavana Kumari KV, Lakkireddy Vasanthi, Srinidhi Kondepudi","doi":"10.3126/ajms.v15i7.65356","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.65356","url":null,"abstract":"Background: The pyramidalis muscle, often considered a minor muscle of the anterior abdominal wall, has variable presence and morphology across populations. Its clinical significance, particularly in surgical interventions involving the suprapubic region, necessitates a detailed understanding of its anatomical features.\u0000Aims and Objectives: This study aimed to assess the incidence, morphometric variations (length, width, and thickness), and clinical relevance of the pyramidalis muscle in the cadaveric population, offering insights that could enhance surgical outcomes in the suprapubic region.\u0000Materials and Methods: It conducted on 60 formalin-fixed cadavers from the Department of Anatomy at Guntur Medical College, Guntur, and Government Medical College, Ongole. This study utilized digital Vernier calipers and measuring tape for precise morphometric analysis. Parameters such as presence, number of bellies, length, width, thickness, and the Pyramidalis Pubo Umbilical Index were meticulously recorded.\u0000Results: The pyramidalis muscle was present in 83.3% of the cases, with 80% bilateral and 3.3% unilateral occurrences. The mean length was 66.2 mm on the right and 64.4 mm on the left. The width at the base averaged 23.4 mm (right) and 22.5 mm (left), with a consistent mean thickness of 4.1 mm on both sides. The Pyramidalis Pubo Umbilical Index was 39.82 (right) and 39.2 (left), indicating little variation between sides.\u0000Conclusion: The pyramidalis muscle exhibits a high incidence rate and specific morphometric characteristics in the cadaveric population. These findings underscore its potential impact on surgical approaches in the suprapubic area, providing valuable anatomical insights for healthcare professionals.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141706847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced serological tests – A paradigm shift in the diagnosis of febrile illnesses even with some atypical manifestations","authors":"Sharmila Gupta","doi":"10.3126/ajms.v15i7.64448","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.64448","url":null,"abstract":"Background: Fever is a symptom, not a disease. It is the non-specific manifestation of several underlying illnesses.\u0000Aims and Objectives: The aims and objectives of this study were to determine the serological profile of patients with febrile illnesses, to study their different unusual presentations, and to study patients with coinfections with more than one type of disease.\u0000Materials and Methods: Blood samples from 15,000 febrile patients were collected during the study period of 6 months. Different serological tests were performed in our laboratory based on clinical suspicion and in a few patients, more than one type of tests were done. The unusual presentations of different diseases were studied.\u0000Results: Various percentages of male and female patients were seen suffering from different types of febrile illnesses. The different positive results out of total tests done for respective diseases were dengue (848/7708), vivax malaria (64/800), falciparum malaria (4/800), leptospirosis (95/798), scrub typhus (77/2433), enteric fever (75/1506), hepatitis B (143/9368), hepatitis C (11/9368), human immunodeficiency virus (HIV) (37/10900), systemic lupus erythematosus (5/158), acute renal failure (66/158), and syphilis (54/583). Different unusual presentations among patients with several diseases were noted, along with their percentages of occurrence. Coinfections among dengue and enteric fever (3%), mixed infection with Plasmodium vivax and Plasmodium falciparum (0.25%), scrub typhus and Leptospira (15.6%), hepatitis B and hepatitis C (0.649%), hepatitis B and HIV (5%), hepatitis C and HIV (8.33%), and syphilis and HIV (27.68%).\u0000Conclusion: Dengue fever was found to be the most common of all febrile illnesses. The different unusual presentations of those diseases should suggest an improved clinical suspicion and better diagnostic stewardship. Coinfection was most commonly seen among syphilis and HIV and these data must suggest to always looking for associated illnesses in a patient with a single diagnosis.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141710115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct observation of procedural skills evaluation of suturing skills in surgical interns: A comprehensive analysis","authors":"Sangameshwar Patil, Anveer Allad, Jyothi Patil, Pavankumar M Patil","doi":"10.3126/ajms.v15i7.64979","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.64979","url":null,"abstract":"Background: The internship period in medical education serves as a critical phase for students transitioning from theoretical learning to practical application within clinical settings. Surgical specialties, in particular, demand a high level of skill and competence from interns due to the inherent risks associated with surgical procedures. However, there is often a gap between the theoretical knowledge gained in medical college and the practical skills required in surgical practice.\u0000Aims and Objectives: Therefore, keeping all the above facts in mind, the present study was undertaken to implement direct observation of procedural skills (DOPS) as a method for evaluating the suturing skills performance in interns.\u0000Materials and Methods: This study focused on an intern in the Department of Surgery, aiming to assess their suturing skills using the DOPS method. A structured workshop was conducted to provide interns with hands-on training in suturing techniques. Subsequently, interns were divided into groups and assessed by assigned assessors using the checklist. Feedback was provided to interns after each assessment session. Data were collected through self-administered questionnaires distributed to interns and assessors, and statistical analysis was performed using SPSS software.\u0000Results: Analysis of the data revealed a significant improvement in suturing skill scores among interns following the implementation of DOPS assessments. Mean scores increased substantially from the initial to subsequent attempts, indicating enhanced proficiency in suturing skills. Interns expressed positive perceptions of the DOPS methodology, highlighting its effectiveness in driving learning and improving confidence in performing surgical procedures.\u0000 Conclusion: DOPS not only facilitates skill development but also promotes confidence and competence in interns, preparing them for clinical practice. Overall, DOPS emerges as a valuable approach for evaluating and improving suturing skills among interns, contributing to their professional development as competent health-care practitioners.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141694348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress hyperglycemia as a prognostic indicator of the clinical outcome in patients with ischemic stroke","authors":"Latha V, Shashibhushan J","doi":"10.3126/ajms.v15i7.65418","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.65418","url":null,"abstract":"Background: Stroke is gaining worldwide importance as the focus now shifts to non-communicable diseases. According to the World Health Organization, over 15 million people, equating to one in every 400 people, suffer stroke worldwide per year. There are many factors which affect the outcome of stroke – artery involved, size of the infarct, associated co-morbidities, age of the patient, collateral blood supply, and many more. Among those one of the factors proposed is stress hyperglycemia (SH).\u0000Aims and Objectives: The aims and objectives of the study are to identify the occurrence of SH in patients admitted with ischemic stroke and to assess the relation of SH in clinical outcomes in patients with ischemic stroke.\u0000Materials and Methods: The prospective study was conducted on patients admitted to medical college hospitals affiliated with VIMS, Ballari. All patients age more than 18 years presenting with acute-onset ischemic stroke were taken into the study, and GRBS was done at presentation and at every 6th hourly for 48 h to identify hyperglycemia. Hemoglobin A1c was done to rule out overt diabetes and previously undiagnosed diabetes mellitus. Clinical outcome and functional recovery using the modified ranking scale (MRS) were done at the time of admission, at discharge, and at every month for 3 months.\u0000Results: Out of 150 patients, 63 (42%) of them had SH. The majority of patients belong to 60–69 years age group. The mean age of patients with SH was 60.2 years and that of patients without SH was 57.75 years. MRS score at the time of admission and during follow-up was higher in SH patients than no SH patients (P<0.001). Patients with SH were more prone to urinary tract infection (n=19 [SH]; n=8 [no SH] P<0.001), bed sores (n=10 [SH]; n=18 [no SH] P<0.008), lower respiratory tract infection (n=30 [SH]; n=34 [no SH], P=0.000), and duration of hospital stay (P=0.000). Delay in presentation to a health facility after the onset of stroke symptoms was found to be a significant contributing factor in SH patients (P<0.003).\u0000Conclusion: The prevalence of SH in ischemic stroke is high. Patients with SH had longer duration of hospital stay, high mortality rate, higher incidence of complications, and poor functional recovery.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between ultrasonography and capnography for ascertaining placement of endotracheal tube in patients undergoing general anesthesia – A prospective observational study","authors":"S. Lahiri, Asim Kumar Kundu, Manjushree Ray","doi":"10.3126/ajms.v15i7.63102","DOIUrl":"https://doi.org/10.3126/ajms.v15i7.63102","url":null,"abstract":"Background: Confirmation of the position of the endotracheal tube (ETT) is an essential step for verification of intubation. Failure to diagnose esophageal intubation may lead to fatal consequences. Capnography is the gold standard for confirmation of ETT position, but it is practically impossible to be performed in all situations. Ultrasonography (USG) or “visual stethoscope” can be used as an effective alternative for all intubators in all situations.\u0000Aims and Objectives: The study was conducted to evaluate the ultrasonography (USG) technique with respect to its efficacy to detect the proper endotracheal position of ETT compared to end-tidal capnography among patients undergoing general anesthesia; to compare the time taken by the USG technique with that of capnography for detection of proper placement of ETT; to assess the feasibility of USG to detect accidental esophageal intubation.\u0000Materials and Methods: This prospective comparative cross-sectional observational study was conducted on 68 patients. Both capnography and upper airway USG were performed immediately after intubation to confirm the ETT placement. Sensitivity, specificity, and positive and negative predictive values of upper airway USG were determined against capnography as the reference method. The time required to determine ETT placement by the two methods was found out and compared. Agreement between the methods was assessed with kappa statistics.\u0000Results: USG detected all three cases of esophageal intubation but could not detect two patients with correct tracheal intubation. Upper airway USG had a sensitivity of 96.92% (95% confidence interval [CI]: 93.54–100%), specificity of 100%, positive predictive value of 100%, and negative predictive value of 60% (95% CI: 50.4–69.6%). The Kappa value was found to be 0.735, indicating a good agreement between upper airway USG and capnography for confirmation of ETT placement. Time taken for confirmation of ETT by capnography was 21.68±2.63 s versus 11.44±1.38 s for upper airway USG (P<0.001). USG demonstrated bilateral lung sliding in 60 (88.2%) patients, unilateral lung sliding in 3 (4.4%) patients, and lung sliding was absent in 5 (7.4%) patients.\u0000Conclusion: Real-time upper airway USG is an alternative method of confirmation of ETT that is not only sensitive and accurate but is faster than the current gold standard method, capnography.","PeriodicalId":8522,"journal":{"name":"Asian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141707247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}