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The developed thick coal seams locked on standing bord and pillar development with a low percentage of extraction has been an enduring problem for Indian geo-mining condition due to strata control issues, methods of mining, equipment selection, ventilation and spontaneous combustion. The occurrences of goaf fire and explosions due to rise in goaf ignition temperature causes substantial property losses and casualties all around the world. It is a threat to the underground coal mine safety. As such no guidelines or methodologies are available for solving the problems of spontaneous heating/fire rising due to depillaring of thick coal seams. The paper addresses, study related to prevention and control of spontaneous heating/ fire in depillaring panels of thick seam mining using laboratory experiments, calculating goaf ignition temperature and computational fluid dynamics (CFD) techniques. The objectives of CFD simulation study is to find out the minimum air quantity requirement for the panel to maintain safe workplace environment and optimize the number of intakes and returns of ventilation system for prevention of spontaneous heating in goaf areas. Field investigations have been carried in Khottadih colliery of Eastern Coalfields Limited (ECL), Sanctoria (West Bengal), India. Laboratory study and field investigation postulates that coal is more prone to spontaneous heating. The simulation study reveals that partial stowing with the incombustible material in the goaf area up to a height of 100 cm is beneficial to prevent spontaneous heating due to roof fall with an air quantity of 2100 m³/min maintaining three intakes and two return airways. [ABSTRACT FROM AUTHOR]

The MPI, GSI and PVPI in SGA were comparable to fetuses with normal growth. To study the Pulmonary vein PI (PVPI), cardiac function (MPI) and geometry (GSI) in growth-restricted fetuses and normally grown fetuses. EP37.08: Pulmonary vein PI, GSI and MPI in growth-restricted and normally grown fetuses. [Extracted from the article]

Here, we report a case of large fetal BPS with massive pleural effusion treated successfully with RFA at 29 weeks of gestation. This was a case of left extrapulmonary BPS (32x25x34 mm) with massive pleural effusion, the blood supply was identified from thoracic aorta. Post procedure the pleural effusion almost resolved by day 7 of procedure, the tumour gradually decreased in size. [Extracted from the article]

Peripartum cardiomyopathy and hypertensive disorders of pregnancy are not very uncommon in routine practice, but when associated with abruptio placentae and significant hypotension, survival of both child and mother becomes challenging. We report a case of a 20-year-old primigravida who presented in the gynecology emergency unit of our hospital with an ejection fraction of < 20%, severe preeclampsia with abruptio placentae leading to fetal demise, and renal failure in the immediate postoperative period. Challenges faced during decision making regarding the mode of delivery and grave concerns during intraoperative and postoperative periods are discussed. In this case, prompt termination of pregnancy, various point-of-care sonographic measurements, and post-operative emergency dialysis played vital roles in the complete recovery of this patient with a failing heart and grossly jeopardized hemodynamics. Hence, multidisciplinary team-based management is crucial for managing such cases to prevent maternal mortality and morbidity., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

Laryngopharyngeal reflux (LPR) can be defined as the regurgitation of gastric acid and peptic substances into the laryngeal and hypopharyngeal regions, even in the case of a singular occurrence. A substantial body of recent research underscores the significance of non-acid reflux as a notable contributor to LPR symptoms. This current investigation delves into the assessment of laryngoscopic observations in their predictive capacity regarding the therapeutic outcomes of empirically administered proton pump inhibitor (PPI) therapy in the context of LPR. In this study, 145 patients who had received a clinical diagnosis of laryngopharyngeal reflux (LPR) underwent rigorous laryngoscopic examinations. These patients were subsequently categorized into three distinct groups based on the Belafsky reflux findings score, which included the criteria for normal (scores ranging from 0 to 7), mild to moderate (scores ranging from 8 to 16), and moderate to severe (scores ranging from 17 to 26). Among the participants, 12 individuals from the normal group, 44 from the mild to moderate group, and 31 from the moderate to severe group reported experiencing a noteworthy alleviation of symptoms following a three-month period of proton pump inhibitor (PPI) therapy and lifestyle adjustments. It is important to note that these findings yielded statistically significant results. Preliminary laryngoscopic observations hold significant potential as predictors of favourable treatment outcomes in the context of empirical proton pump inhibitor (PPI) therapy for laryngopharyngeal reflux (LPR)., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: Opioids administered as bolus doses or continuous infusions are widely used for major and daycare surgeries. Opioid-free anesthesia is multimodal anesthesia and analgesia that does not use opioids, benefiting patients from opioid-related adverse effects. We compared the postoperative analgesic requirements of patients scheduled for elective laparoscopic cholecystectomy under opioid-free and opioid-based anesthesia., Methods: Study included 88 patients aged 18-60 years with American Society of Anesthesiologists physical status 1 and 2 who underwent elective laparoscopic cholecystectomy. Participants were randomly divided into two groups with 44 in each. The opioid-free group was administered an intravenous bolus of ketamine and dexmedetomidine, whereas fentanyl was used in opioid group. Primary outcome was to compare the total amount of fentanyl consumed by both groups during 6 h postoperative period. Episodes of postoperative nausea and vomiting (PONV) and vital signs were noted throughout the postoperative period to analyze the secondary outcomes., Results: Both groups had similar demographic characteristics. The opioid-free group required lesser analgesia within the first 2 h (61.4 ± 17.4 vs. 79.0 ± 19.4 of fentanyl, P < 0.001), which was statistically significant. However, fentanyl consumption was comparable between the groups at 6 h (152 ± 28.2 vs. 164 ± 33.4, P = 0.061). Compared with 4.5% of the participants in the opioid-free group, 34% of those in the opioid-based group developed moderate PONV., Conclusions: Opioid-free anesthesia in patients undergoing laparoscopic cholecystectomy reduced the requirement of analgesia in first two-hour postoperative period and was associated with decreased PONV.

Competing Interests: Competing interests: None declared.

Competing Interests: There are no conflicts of interest.

Background and Aims: Considerable importance has been attached to early recovery and discharge readiness after surgeries. Many centers use total intravenous anesthesia (TIVA) as their anesthesia technique of choice. Target-controlled infusions (TCI) have been proposed as a method to precisely deliver continuous infusions of propofol and opioids as compared to the traditionally used manual-controlled infusion (MCI) methods. However, TCI has also been shown to result in the administration of larger doses of propofol which could cause delayed emergence and recovery from anesthesia. Studies involving TCI have focused mainly on its effects on anesthesia induction but not much literature is available on recovery profiles of patients on TCI. This study was designed to compare the effect of conventionally used MCI methods versus the target-controlled infusion (TCI) method of administering TIVA on recovery characteristics in patients undergoing laparoscopic surgery., Material and Methods: This was a prospective randomized interventional study on 54 patients. Our primary objective was to compare the rates of recovery from anesthesia as judged by four parameters. Time to return of spontaneous ventilation, time to respond to verbal commands, time to extubation, and time to shift patient out of the operating room after stoppage of propofol infusion. As secondary objectives, intraoperative average bispectral index (BIS) values and total anesthetic drugs (propofol and fentanyl) consumption were also compared., Results: We noted that for laparoscopic surgeries lasting less than 4 hours, both MCI and TCI techniques of TIVA have comparable rates of recovery after the stoppage of propofol infusion. Total consumption of propofol and fentanyl was also similar; however, with the use of the TCI method of TIVA, better depth of anesthesia as evidenced by lower average BIS levels was noted., Conclusion: Recovery rates after TIVA using a target-controlled infusion (TCI) system are similar to BIS-guided MCIs in patients undergoing laparoscopic surgery lasting less than 4 hours. TCI resulted in better depths of anesthesia though per kg/min consumption of propofol was found to be more., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Anaesthesiology Clinical Pharmacology.)

Advances in artificial intelligence, telemedicine, block-chain technology and electronic medical records are paving the way for a new era in anaesthetic care through automation, non-invasive monitoring, system management and decision support systems. Their utility has been demonstrated in a variety of contexts in the peri-operative setting, including but not limited to, monitoring anaesthesia depth, maintaining drug infusion, predicting hypotension, critical incident evaluation, risk management strategies, antibiotic administration, haemodynamic monitoring, precise ultrasound-guided nerve blocks and a future where possibilities are entirely dependent on how we decide to embrace this progression. The main objective of this article is to provide up-to-date and valuable knowledge about the recent advances in anaesthesia technology during the past few years., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Anaesthesia.)

Background: This telephonic survey was aimed to identify the proportion of coronavirus disease-2019 (COVID-19) patients who died from any cause, within 6 months of discharge from a tertiary COVID-19 care hospital. We also analyzed whether any clinical and/or laboratory variables were associated with post-discharge mortality., Materials and Methods: All adult patients (age ≥18 years) who had been discharged during the period between July 2020 and August 2020 from a tertiary COVID-19-care hospital after initial hospitalization for COVID-19 were included. A telephonic interview was conducted 6 months after discharge to assess morbidity and mortality in these patients., Results: Out of the 457 patients who responded, 79 patients (17.21%) were symptomatic, and breathlessness was found as most common symptom (6.12%). Fatigue was noted in (5.93%) of study patients, followed by cough (4.59%), sleep disturbances (4.37%), and headache (2.62%). Of the 457 patients who responded, 42 patients (9.19%) required expert medical consultation for their persistent symptoms. Thirty-six patients (7.88%) required re-hospitalization for post-COVID-19 complications within 6 months of discharge. A total of 10 patients (2.18%) succumbed within 6 months of their discharge from the hospital. 6 patients were males and 4 females. Most of these patients (7/10) succumbed in the second month after discharge. Seven patients had moderate-to-severe COVID-19 disease and most of these (7/10) had not been treated in the intensive care unit (ICU)., Conclusion: Post-COVID-19 mortality figures were not very high in our survey despite the high perceived risk of thromboembolic events after recovery from COVID-19. A significant proportion of patients reported persistent post-COVID-19 symptoms. Breathing difficulty was the most common symptom noted by us, closely followed by fatigue., How to Cite This Article: Rai DK, Sahay N. Six-month Morbidity and Mortality in Patients after Recovery from COVID-19. Indian J Crit Care Med 2022;26(11):1179-1183., Competing Interests: Source of support: Nil Conflict of interest: Nil, (Copyright © 2022; Jaypee Brothers Medical Publishers (P) Ltd.)

Competing Interests: There are no conflicts of interest.

Background and Aims: Many health care staff have been pressed into coronavirus disease-19 patient care with little experience of working in bio-hazard zones because of the overwhelming requirements of manpower. They wear personal protective equipment (PPE) and follow all rules for their safety. However, despite precautions, during doffing, they carry a risk of self-contamination. This randomised cross-over study assessed the risk of self- contamination because of improper doffing of PPEs., Methods: A colourless lotion that glows with a bright-green fluorescent hue under ultraviolet light was applied to simulate germ contamination in various health care workers (HCWs) who volunteered for the study. The primary objective of this study was to know the percentage of HCWs getting self-contaminated. The secondary objectives were to assess which portions of the body get maximally contaminated and infestation of germs on which portions of the PPE carry more risk of self-contaminating after doffing., Results: A total of 152 doffings by 76 participants were analysed, and the volunteers self-contaminated in 43 doffings (28.28%). In 18 of these 43 doffings, self-contamination was noted at more than one location. The most commonly contaminated areas were the arms (33%), clothes on the abdomen (24%), and areas in the lower limb (23%). Germ infestation on the upper parts of a PPE is 2.39 times more likely to cause self-contamination after improper doffing., Conclusion: Faulty doffing resulted in self-contamination in 28.28% of all doffings. Risk is 2.39 times more when germs are nested in the upper body portions of the PPE suit., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Indian Journal of Anaesthesia.)

Competing Interests: There are no conflicts of interest.

A dissertation is a practical exercise that educates students about basics of research methodology, promotes scientific writing and encourages critical thinking. The National Medical Commission (India) regulations make assessment of a dissertation by a minimum of three examiners mandatory. The candidate can appear for the final examination only after acceptance of the dissertation. An important role in a dissertation is that of the guide who has to guide his protégés through the process. This manuscript aims to assist students and guides on the basics of conduct of a dissertation and writing the dissertation. For students who will ultimately become researchers, a dissertation serves as an early exercise. Even for people who may never do research after their degree, a dissertation will help them discern the merits of new treatment options available in literature for the benefit of their patients., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Indian Journal of Anaesthesia.)

Objectives of the Study: The objectives of the study were to assess the mortality among critically ill coronavirus disease (COVID) patients and to look at the factors which could have a bearing on mortality of these patients presenting to our designated tertiary COVID care institute., Method: This was a retrospective observational study involving all adult patients admitted to our intensive care unit (ICU) with coronavirus disease-2019 (COVID-19) infection between June 30, 2020, and August 31, 2020. We compared patient-related factors and laboratory test results among all survivors vs nonsurvivors in our ICU with an aim to predict the factors which could predict increased risks of mortality among sick patients admitted to our ICU., Results and Conclusion: The overall ICU mortality in our ICU during the study period was 76.69% and less than 5% of the patients requiring mechanical ventilation within 1 day of admission, survived. More than half of the deaths (54.66%) occurred within 5 days of ICU admission. The best predictors for mortality based upon the Cox proportional hazard ratio are increasing age, neutrophilia, increased D-dimer, prolonged stay in ICU for 1-2 weeks, and those requiring mechanical ventilation. Patients with one or more comorbidities were noted to have 16% of higher risk of death than those without any comorbidity., How to Cite This Article: Rai DK, Sahay N, Lohani P. Clinical Characteristics and Treatment Outcomes of 293 COVID-19 Patients Admitted to the Intensive Care Unit of a Tertiary Care Hospital of Eastern India. Indian J Crit Care Med 2021;25(12):1395-1401., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.)

Competing Interests: There are no conflicts of interest.

Objective: Quadratus lumborum (QL) block has emerged as a good option to be included in multimodal analgesia for abdominal surgeries. The aim of the present study was to compare the effectiveness of the QL block with the more established transversus abdominis plane (TAP) block along with a control group in terms of duration of analgesia as the primary outcome in total abdominal hysterectomy (TAH)., Methods: This randomised, double-blind, controlled trial was performed after ethics committee approval and written informed consent. Ultrasound-guided QL (group Q) and TAP (group T) blocks were administered on either side using 20mL of 0.25% bupivacaine after surgery under general anaesthesia, and group C did not receive any intervention., Results: There was a significant difference in the duration of analgesia among the groups (P ¼ .00). It was significantly longer in group Q (mean ¼ 8.05 hours; 95% CI, 7.28, 8.81) compared to group T (mean ¼ 5.59 hours; 95% CI, 4.63, 6.45) and group C (mean ¼ 1.19 hours; 95% CI, 1.04, 1.34). The verbal rating score (P ¼ .001) and the cumulative analgesic consumption (P ¼ .00) were the least in group Q. There was no complication in any of the groups. However, the level of satisfaction in patients receiving QL blocks did not differ significantly than in those receiving TAP block., Conclusion: It is highly recommended to include QL block as a part of multimodal analgesia in TAH as it is superior to TAP block in analgesic effect.

Competing Interests: There are no conflicts of interest.

Competing Interests: There are no conflicts of interest.

Background and Aims: Newer supraglottic devices with an additional gastric channel offer greater protection from aspiration and avoidance of laryngoscopy for their insertion would result in attenuated hemodynamic responses.The primary objective was to assess hemodynamic responses to insertion of Baska mask as compared to tracheal intubation. The time and attempts taken to secure airway and evidence of regurgitation and pulmonary aspiration of gastric contents were also assessed., Material and Methods: This prospective, randomized study was conducted in 80 patients undergoing laparoscopic cholecystectomy. All patients received standardized anaesthesia protocol. Baska mask was used to secure airway in Group B, while tracheal intubation was done in group T. Methylene blue was injected through Ryle's tube into stomach in both groups. At end of surgery, fibreoptic bronchoscopy was performed to detect bluish staining of trachea and/or main bronchi as evidence of aspiration of gastric contents and bluish staining in oropharynx as evidence of regurgitation. Chi-square test and Independent sample t-test were applied., Results: The time taken to secure airway was significantly longer in Group B as compared to Group T (45.3 ± 12.6 vs. 24.3 ± 9.1 sec) Percentage of patients who had oropharyngeal blue stain was comparable in both groups. No patient in both groups had tracheal blue stain. Group T had significantly higher HR and MAP after intubation till 10 min later., Conclusion: Baska mask insertion was associated with attenuated hemodynamic responses, though more time and attempts were required for securing the airway. It could be considered as an alternative to tracheal intubation during laparoscopic surgeries., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Anaesthesiology Clinical Pharmacology.)

How to cite this article: Naaz S, Kumar A, Sahay N, Kumar R, Ozair E, Valiaparambath A. Defecation and Micturition may Cause Syncope in COVID-19 Patients on High Oxygen Requirement. Indian J Crit Care Med 2021;25(5):599-600., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.)

Competing Interests: There are no conflicts of interest.

Extant legislation, professional and societal ethics provide fundamental guidance to professionals in practising their profession. Legal rules are enforced by courts of law whereas rules of ethics are enforced by professional bodies like the Medical Council of India (now National Medical Commission). In this article, we explore some of the principal guidelines that regulate medical ethics. The role of informed written consent is vital in safeguarding the patient as well the doctor's interests; the approach for getting consent will differ depending on patient and procedure. Medical records document every aspect of the patient's history and details of the procedure and are the only means to settle disputes as they provide legitimate, real-time and accurate details of events that have occurred in the past. Although not explicitly listed as a 'service' in the Consumer Protection Act (CPA), healthcare-related complaints can be filed under the Consumer court and the precedent has been established that it is a service. CPA of 2019 provides detailed regulations for performing scrutiny of cases, fines that can be levied, the directives for seeking compensation, etc., Every anaesthesiologist must have some knowledge of law and ethics in order to protect himself/herself from avoidable litigation or disciplinary action., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Indian Journal of Anaesthesia.)

How to cite this article: Naaz S, Sahay N, Kumar R, Kumar A, Asghar A. Prolonged Use of Supraglottic Airway Device for Mechanical Ventilation in the Intensive Care Unit. Indian J Crit Care Med 2020;24(10):1001-1002., Competing Interests: Source of support: Nil Conflict of interest: None, (Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.)

Competing Interests: There are no conflicts of interest.

Competing Interests: There are no conflicts of interest.

Context: Many minor gynecological procedures are done for diagnostic and therapeutic reasons. A balance has to be struck between ability to discharge a patient at the earliest with minimum procedure-related discomfort to ensure patient safety as well as satisfaction., Aim: This prospective randomized study was designed to compare deep sedation versus paracervical block for minor gynecological surgeries comparing the time to discharge readiness, pain after the procedure, and overall patient satisfaction., Setting and Design: This prospective randomized comparative study was conducted at a tertiary level hospital after institutional ethics committee approval and registry of trial at CTRI (India)., Methods: Seventy young women underwent minor gynecological procedures under these two modes of anesthesia. Time to discharge readiness from hospital to home was assessed using modified postanesthesia discharge score system (PADSS). Pain after procedure as well as patient satisfaction was evaluated. Patients were also asked whether they would recommend the same anesthetic technique for the procedure in the future. Answers were noted on a Likert scale., Results: Patients were ready to be discharged faster in deep sedation group compared to paracervical block group based upon modified PADSS score (1 h 9.6 min vs. 1 h 18 min) ( P = 0.005). Pain in the perioperative period was analyzed using repeated-measures ANOVA and found to be significantly lesser in deep sedation group when considered till 80 min after surgery. The mean satisfaction score in patients who underwent deep sedation was 91.24 (standard deviation [SD] 2.8) compared to patients given paracervical block which was low at 64.67 (SD 15.8). All patients given deep sedation were ready to recommend the anesthesia technique as compared to only 53.3% of patients who were given paracervical block., Conclusions: Deep sedation may be preferred over paracervical block for daycare minor gynecological procedures., Competing Interests: There are no conflicts of interest., (Copyright: © 2019 Gynecology and Minimally Invasive Therapy.)

Background and Aims: Laparoscopic surgeries cause an increase in intracranial pressure (ICP) after creation of pneumoperitoneum. Sonographically measured, optic nerve sheath diameter (ONSD) correlates well with changes in ICP. Dexmedetomidine (Dex), an α 2 agonist is extensively used in day-care surgeries, although its effect on ICP during laparoscopy in humans has not been reported in the literature. The aim of this study was to note the effect of dexmedetomidine infusion on changes in ICPs during laparoscopic cholecystectomy., Material and Methods: This was a prospective, randomized, placebo-controlled, double-blind study done on 60 patients scheduled for laparoscopic cholecystectomy. The study drug, dexmedetomidine hydrochloride (Dex) or placebo saline infusion, was started 10 min before induction and continued till extubation. Changes in ICP were assessed sonographically at baseline before pneumoperitoneum, 5 min after establishing pneumoperitoneum, 10 min after positioning the patient 20° head up, and 5 min after desufflation., Results: Demographically, both groups were comparable. The ONSD showed a significant increase after pneumoperitoneum in both groups ( P = 0.0001 and 0.0011). Dex group could marginally attenuate this increase ( P = 0.075). After changing patient's position to reverse Trendelenburg, ONSD increased further in both groups. Dex group could significantly attenuate the increase ( P = 0.001). The ONSD did not return to baseline values till after 5 min of release of pneumoperitoneum in both groups., Conclusion: Dexmedetomidine is effective in attenuating increase in ICP associated with laparoscopic surgeries. The benefit was marked 10 min after placing patient in the reverse Trendelenburg position during laparoscopic cholecystectomy., Competing Interests: There are no conflicts of interest.