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Dwivedi D, Chakravarty J, Mateen MA, Bhatia JS. Deliberate anaesthesia gas scavenging system check, a need for averting disasters. Indian J Anaesth 2022; 66:S226-S228. [PMID: 35874491 PMCID: PMC9298931 DOI: 10.4103/ija.ija_766_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/28/2021] [Accepted: 04/15/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Deepak Dwivedi
- Department of Anaesthesia and Critical Care, Command Hospital (Eastern Command) Alipore, Kolkata, West Bengal, India,Address for correspondence: Dr. Deepak Dwivedi, Department of Anaesthesia and Critical Care, Command Hospital (Eastern Command) Alipore, Kolkata - 700 027, West Bengal, India. E-mail:
| | - Jayanta Chakravarty
- Department of Anaesthesia and Critical Care, Command Hospital (Eastern Command) Alipore, Kolkata, West Bengal, India
| | - Mohammad A. Mateen
- Department of Anaesthesia and Critical Care, Command Hospital (Eastern Command) Alipore, Kolkata, West Bengal, India
| | - Jagdeep S. Bhatia
- Department of Anaesthesia and Critical Care, Command Hospital (Eastern Command) Alipore, Kolkata, West Bengal, India
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Eastern and North-Eastern supplement of the IJA……….: Rising of a new dawn in Eastern and North-Eastern academics. Indian J Anaesth 2022; 66:S184-S185. [PMID: 35874486 PMCID: PMC9298933 DOI: 10.4103/ija.ija_459_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ahluwalia P, Gupta B. Electronic pre-anaesthetic checkups (E-PAC) and digital informed consent before elective procedures: Is it time to break the cliche? Indian J Anaesth 2022; 65:909-910. [PMID: 35221366 PMCID: PMC8820331 DOI: 10.4103/ija.ija_751_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/24/2021] [Accepted: 12/04/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Pallavi Ahluwalia
- Department of Anaesthesia, Teerthanker Mahaveer Medical College, Moradabad, Uttar Pradesh, India
| | - Bhavna Gupta
- Department of Anaesthesiology, AIIMS, Rishikesh, Uttarakhand, India
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Pandey VK, Prabhudesai AA, Gupta S. Acute respiratory distress after liver transplantation in infants-looking beyond infection and hepatopulmonary syndrome: A brief report. Indian J Anaesth 2022; 65:843-844. [PMID: 35001961 PMCID: PMC8680426 DOI: 10.4103/ija.ija_435_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Vijay K Pandey
- Anaesthesiology and Critical Care, Max Super Speciality Hospital, Saket, New Delhi, India
| | - Aaditya A Prabhudesai
- Anaesthesiology and Critical Care, Max Super Speciality Hospital, Saket, New Delhi, India
| | - Subhash Gupta
- Liver Transplant Surgery, CLBS, Max Super Speciality Hospital, Saket, New Delhi, India India
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Deo A, Kashyapi R, Joshi V, Balakundi P, Raman P. Predictors of peri-operative cardiac events and development of a scoring tool for patients with chronic kidney disease undergoing non-cardiac surgeries: A prospective observational multicentre study. Indian J Anaesth 2022; 66:278-289. [PMID: 35663210 PMCID: PMC9159394 DOI: 10.4103/ija.ija_1031_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 11/25/2022] Open
Abstract
Background and Aims: Cardiovascular diseases are the leading causes of morbidity and mortality in chronic kidney disease (CKD) patients. Our aim was to derive predictors of cardiac morbidity, mortality, cardiac complications and to develop/validate a scoring tool in patients with CKD undergoing non-cardiac surgery. Methods: A prospective observational multicentre study was done on 770 patients with CKD. The primary outcome (“Event”) was one or more than one of sudden cardiac death, pulmonary oedema, acute coronary syndrome, arrhythmia and 30-day mortality. Secondary outcome was hypertension and hypotension. Predictors of cardiac risk were identified. A scoring tool was developed on the 2018 dataset and was validated on the 2019 dataset. Results: The overall incidence of cardiac events was 290 (37.66%) whereas the incidence of major adverse cardiac and cerebrovascular events was 15.04%. Mortality due to cardiac cause was 13 (1.68%). On multivariate regression analysis, seven perioperative variables had significant association with increased risk of events: age > 65 years (P = 0.004), metabolic equivalents (METS) ≤4 (P≤0.032), emergency surgery (P =0.032), mean arterial pressure >119 (P = 0.001), echocardiographic scoring (P = 0.054), type of anaesthesia (P ≤ 0.0001) and type of surgery (P = 0.056). Using these variables, a risk stratification tool was developed. C statistics showed favourable predictive accuracy (0.714) and the model showed good calibration. Conclusion: This risk scoring tool based on preoperative variables will help to predict the risk of events in high-risk CKD patients undergoing non-cardiac surgery. This will help in better counselling and optimisation.
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Shivali S, Thiagarajan P. A practical guide to the American Society of Anesthesiologists-physical status classification (ASA-PS). Indian J Anaesth 2022; 66:299-300. [PMID: 35663220 PMCID: PMC9159401 DOI: 10.4103/ija.ija_526_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 12/15/2021] [Accepted: 03/28/2022] [Indexed: 12/04/2022] Open
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Nileshwar A, Ahuja V, Kini P. Evaluation of the electronic stethoscope (FONODOC) as a cardiac screening tool during the preoperative evaluation of children. Indian J Anaesth 2022; 66:625-630. [PMID: 36388445 PMCID: PMC9662099 DOI: 10.4103/ija.ija_305_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/17/2022] [Accepted: 08/31/2022] [Indexed: 11/23/2022] Open
Abstract
Background and Aims: An electronic stethoscope with an inbuilt phonocardiogram is a potentially useful tool for paediatric cardiac evaluation in a resource-limited setting. We aimed to compare the acoustic and electronic stethoscopes with respect to the detection of murmurs as compared to the transthoracic echocardiogram (TTE). Methods: This was an observational study. Fifty children aged 0–12 years with congenital heart diseases (CHDs) and 50 without CHD scheduled for echocardiography were examined using both stethoscopes. The findings were corroborated with clinical findings and compared with the echocardiography report. Results: Among the 50 cases without CHD, no murmur was detected using either of the stethoscopes. This was in agreement with TTE findings. The calculated specificity of both stethoscopes was 100%. Amongst the 50 cases with CHD, the electronic stethoscope picked up murmurs in 32 cases and missed 18 cases. The acoustic stethoscope picked up murmurs in 29 cases and missed 21 cases. Thus, the sensitivity of electronic and acoustic stethoscopes as compared to TTE was calculated to be 64% and 58%, respectively. The positive predictive value of the electronic stethoscope as compared to TTE was 100% while the negative predictive value was 73%. The kappa statistic was 0.93 suggesting agreement in 93%. Mc-Nemar’s test value was 0.24 suggesting that the electronic stethoscope did not offer any advantage over the acoustic stethoscope for the detection of CHD in children. Conclusion: A comparison of the electronic stethoscope with an acoustic stethoscope suggests that the rate of detection of CHD with both stethoscopes is similar and echocardiography remains the gold standard.
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Malviya D, Singh Bajwa S, Kurdi M. Striving towards excellence in research on biomarkers. Indian J Anaesth 2022; 66:243-247. [PMID: 35663215 PMCID: PMC9159397 DOI: 10.4103/ija.ija_319_22] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/08/2022] [Accepted: 04/08/2022] [Indexed: 01/08/2023] Open
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Chalasani S, Gurudatt CL, Ramesh M. Patient satisfaction, outcomes and experience measures in patients receiving general anaesthesia: A prospective questionnaire based observational study. Indian J Anaesth 2022; 66:224-228. [PMID: 35497696 PMCID: PMC9053884 DOI: 10.4103/ija.ija_945_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 01/08/2022] [Accepted: 03/02/2022] [Indexed: 11/06/2022] Open
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Mirakbari S, Kazemifar A, Namdar P, Seddighi M, Allami A, Barikani A. Comparison of elevated cardiac troponin I with SAPS-II and APACHE-II score in predicting outcome of severe intoxications. Indian J Anaesth 2022; 66:248-254. [PMID: 35663208 PMCID: PMC9159406 DOI: 10.4103/ija.ija_465_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 12/03/2021] [Accepted: 03/28/2022] [Indexed: 12/02/2022] Open
Abstract
Background and Aims: To date, different methods have been invented to risk-stratify critically ill patients, however, there is a paucity of information regarding assessing the severity of poisonings. This study was designed to determine the comparative efficacy of Simplified Acute Physiology Score-II (SAPS-II) and Acute Physiology and Chronic Health Evaluation-II (APACHE-II)score with cardiac troponin I (cTnI) in predicting severe intoxication outcomes. Methods: This was a prospective study conducted on patients who fulfilled defined severe intoxication criteria necessitating intensive care unit (ICU) admission over a period of 6 months. SAPS-II and APACHE-II scores were calculated and cTnI concentrations were measured. These indicators were compared to determine which has the better ability to prognosticate mortality and complications. Results: A total of 55 cases (median age, 35 [24-49] years) were enroled. Eight patients (14.5%) died. Mean SAPS-II, median APACHE-II score and median cTnI concentrations were 32.05 ± 11.24, 13 [10-17] and 0.008 [0.002-0.300] ng/ml, respectively, which were significantly different between the survivors and non-survivors. Receiver operating characteristics curve results of SAPS-II, APACHE-II score and cTnI concentrations in predicting mortality were 0.945, 0.932 and 0.763 and in predicting complications were 0.779, 0.739 and 0.727, respectively. High cTnI concentration (>0.37 ng/ml) correlated with soft clinical outcomes, including length of ventilatory support, length of ICU stay and length of hospital stay (LOS) (r: 0.928, 0.881 and 0.735 respectively; all P < 0.001). Conclusion: SAPS-II scores were superior in predicting death and complications, while cTnI correlated more closely with soft clinical outcomes, such as the length of ventilator support, length of ICU stay or LOS.
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Singh Bajwa S, Mehdiratta L, Kurdi M. In pursuit of excellence in anaesthesia education….vision, challenges and opportunities. Indian J Anaesth 2022; 66:3-7. [PMID: 35309024 PMCID: PMC8929314 DOI: 10.4103/ija.ija_43_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 11/04/2022] Open
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Bajwa SJS, Kurdi MS, Sutagatti JG, Bajwa SK, Theerth KA. Point-of-Care Ultrasound (POCUS) for the assessment of volume status and fluid management in patients with severe pre-eclampsia: A systematic review and meta-analysis. Indian J Anaesth 2021; 65:716-730. [PMID: 34898698 PMCID: PMC8607863 DOI: 10.4103/ija.ija_820_21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND AND AIMS Appropriate volume assessment and fluid management can prevent maternal deaths in the severely pre-eclamptic (SPE) parturients. We planned a systematic review and meta-analysis (MA) to evaluate the role and ability of point-of-care ultrasound (POCUS) in the assessment of volume status and early detection of lung oedema in an SPE parturient. METHODS An e-literature search was done from several databases. Data were extracted under five domains including POCUS-derived parameters like echo comet score (ECS), lung ultrasound (LUS) scores, B-patterns, optic nerve sheath diameter (ONSD), E/e' ratio, presence of pleural effusion, pulmonary interstitial syndrome and pulmonary congestion. The risk of bias was assessed. Extracted data were analysed using MetaXL and Revman 5.3. Heterogeneity in the studies was evaluated using the Cochrane Q test and I2 statistics. Funnel plots were used for the assessment of publication bias. RESULTS Seven prospective studies including 574 parturients (including 396 pre-eclamptics) were selected. POCUS included lung, optic nerve, cardiac and thoracic US. In two studies, the ECS and LUS scores pre-delivery were higher in pre-eclamptics. Two studies found a mean ONSD of 5-5.84 mm before delivery. MA revealed a significantly lower mean ECS score at post-delivery than pre-delivery, and the summary prevalence of B-pattern and pleural effusion among SPE parturients was found to be 0.28 (0.03-0.84) and 0.1 (0-0.2), respectively. A good correlation was observed between B-line patterns and diastolic dysfunction (increased E/e' ratio), LUS score and thoracic fluid content, ONSD and ECS in individual studies. CONCLUSION POCUS parameters can be useful as early markers of fluid status and serve as useful tools in the precise clinical management of pre-eclampsia.
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Affiliation(s)
- Sukhminder Jit Singh Bajwa
- Department of Anaesthesiology and Intensive Care, Gian Sagar Medical College and Hospital, Banur, Patiala, Punjab, India
| | - Madhuri S. Kurdi
- Department of Anaesthesiology, Karnataka Institute of Medical Sciences (KIMS), Hubballi, Karnataka, India
| | - Jagadish G. Sutagatti
- Department of Radiodiagnosis, Karnataka Institute of Medical Sciences (KIMS), Hubballi, Karnataka, India
| | - Sukhwinder K. Bajwa
- Department of Obstetrics and Gynaecology, Bajwa Maternity and Nursing Home, Patiala, Punjab, India
| | - Kaushic A. Theerth
- Department of Anaesthesiology, Medical Trust Hospital, Ernakulum, Kerala, India
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Mehdiratta L, Kumar N, Bajwa SJS. Advancing, strengthening and reshaping obstetric critical care with Point-of-Care Ultrasound (POCUS). Indian J Anaesth 2021; 65:711-715. [PMID: 34898697 PMCID: PMC8607862 DOI: 10.4103/ija.ija_924_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 12/16/2022] Open
Affiliation(s)
- Lalit Mehdiratta
- Department of Anaesthesiology, Critical Care and Emergency Medicine, Narmada Trauma Centre, Bhopal, Madhya Pradesh, India
| | - Nishant Kumar
- Department of Anaesthesiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Sukhminder Jit Singh Bajwa
- Department of Anaesthesiology and Intensive Care, Gian Sagar Medical College and Hospital, Banur, Patiala, Punjab, India
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Nair A, Kalbani S. Role of mobile applications for the success of enhanced recovery after surgery programme. Indian J Anaesth 2021; 65:914-915. [PMID: 35221369 PMCID: PMC8820338 DOI: 10.4103/ija.ija_471_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 11/13/2022] Open
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Nakadate Y, Takamino A, Nakashige D, Ikemoto K. Role of postoperative anaesthesia visits in hoarseness following surgery. Indian J Anaesth 2021; 65:901-905. [PMID: 35221363 PMCID: PMC8820325 DOI: 10.4103/ija.ija_589_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/19/2021] [Accepted: 12/06/2021] [Indexed: 12/14/2022] Open
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