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Background: Preemptive analgesia is a method of administration of drugs prior to surgery involving blocking noxious stimuli across the perioperative period. It involves blocking the pain pathway preemptively before injury-induced hypersensitivity manifests. Objective: To compare the analgesic efficacy of duloxetine with pregabalin as preemptive analgesic in lumbar spine surgeries. Design: Randomised, double-blinded, prospective study. Methods: Fifty patients of both sexes between 18-55yrs undergoing elective lumbar spine surgery were randomly allocated into two groups, group P and group D of twenty-five patients each. Group P received 75 mg pregabalin once daily for three days, followed by 150 mg pregabalin daily for the next four days till the day of surgery. Group D received 20 mg duloxetine once daily for three days, followed by 40 mg duloxetine twice daily for the next four days till the day of surgery. Outcome Measure: Both the groups were primarily evaluated in terms of time for request of 1st rescue analgesic and total intraoperative analgesic requirement in terms of fentanyl boluses required; among other parameters. Results: The time for request of 1st rescue analgesic postoperatively was significantly longer in the pregabalin group (396 ± 267.77 min) than in the duloxetine group (218.4 ± 96.9 min), P = 0.003. Pregabalin recipients required considerably less rescue analgesics in terms of dosage, P = 0.006. Also, pregabalin exhibited better postoperative pain control than duloxetine as reflected by NRS comparative scores. No statistical difference was appreciated in terms of intraoperative fentanyl requirement, intraoperative hemodynamic control; nausea and sleepiness. Conclusion: Pregabalin is more efficacious as a preemptive analgesic than duloxetine in lumbar spine surgery. [ABSTRACT FROM AUTHOR]

Background: The study aimed to investigate the effects of spinal anaesthesia on patients with hypotension and bradycardia. The procedure was uneventful, with no conversions from spinal to general anaesthesia. The study found significant variations in pulse rate after spinal and during GB handling in group S, which may be due to vagal stimulation or hemodynamic response to laryngoscopy and intubation. Bradycardia was an expected side effect due to rapid peritoneal stretch and vagal stimulation in laparoscopic cholecystectomy operations. The incidence of bradycardia was 11.43% and 2.86% in group S and group G, respectively. Aim and objectives: Hypotension and bradycardia were easily managed with inj. Mephentermine and inj. Atropine, respectively. Pre-anaesthetic hydration with 10ml/kg of ringer lactate prevented repeated hypotension occurrences. The decrease in pulse rate and BP in group S was due to the residual analgesic effect of local anaesthetic in subarachnoid space. Methods: Shore tip pain was a significant intraoperative problem caused by the irritation of the subdiaphragmatic area with CO2. Previous studies have shown that maintaining intraabdominal pressure below 10 mmHg reduces right shoulder pain and respiratory distress due to diaphragm irritation. However, the study's high intraabdominal pressure created during pneumoperitoneum affected hemodynamic values negatively and contributed to shoulder pain. Results: The surgical team was satisfied with sufficient abdominal relaxation during the operation in spinal anaesthesia. However, further studies with a larger sample size may be conducted to support observations. All patients in the spinal anaesthesia group remained awake and oriented at the end of surgery, with a smooth transition of pain in the postoperative period. Avoidance of GA and opioids contributed to the lack of deterioration in cognitive function. [ABSTRACT FROM AUTHOR]

Tracheostomy is a common airway procedure for life support in critically ill patients with head injuries. This procedure is safe but also associated with early and late complications. Tube fracture and dislodgement into the tracheobronchial tree leading to airway obstruction is a rare but life-threatening complication after prolonged tracheostomy tube placement. There are very few published reports of tracheostomy tube fracture and dislodgement into tracheobronchial tree in a neurologically injured patient. We report a case of a fractured tracheostomy tube which got impacted in the left main bronchus, in a 41-year-old male patient who had been on prolonged tracheostomy tube after craniotomy and evacuation of subdural hematoma. The distal part of the tracheostomy tube fractured and impacted in the left main bronchus. Fibreoptic bronchoscopy was performed through the oral cavity to extract it, and the anaesthetic management during the period is discussed. [ABSTRACT FROM AUTHOR]

The purpose of this case series is to see how successful HFNOT is at preventing postoperative hypoxemia and improving oxygenation in patients undergoing emergency abdominal operations. All the patients were put on High flow nasal oxygen therapy (HFNOT) with a flow rate of 40-60 Litre/min and a FiO2 of 40% after a successful spontaneous breathing trial (SBT). At 12 and 24 hours after extubation, there was a considerable improvement in oxygenation (p < 0.0001), as evidenced by an increase in PaO2 values (128± 5.86, 147± 6.70) and improvement in PaO2/FiO2 (320±14.69, 367.9±16.52). We found that HFNOT improves oxygenation in emergency abdominal surgery patients 12 and 24 hours after extubation. [ABSTRACT FROM AUTHOR]

Background: The use of ultrasonography (USG) to identify fascial layers has led to the development of several newer interfascial techniques for analgesia of the chest and abdominal wall. Two such modalities are the Pectoral nerve block (PEC) and Serratus Anterior Plane (SAP) block. Objective: To compare the duration and quality of analgesia provided by ultrasound-guided SAP block with PEC block II in patients undergoing breast surgeries after induction of general anesthesia. Design: Randomized, double-blinded, prospective study. Methods: Sixty female patients were divided into two groups of 30 each. Patients in Group P received USG guided PEC II block, whereas patients in Group S received USG-guided SAP block after induction. Outcome Measure: The primary objective was to compare the duration of pain relief, whereas the secondary objectives were to compare the degree of pain relief, postoperative analgesic requirement within 24 h after the completion of the surgery, patient satisfaction score and complications if any. Results: The mean time of the first dose of analgesic given was 826 ± 405.24 min. in Group P and 1280 ± 264.29 min. in Group S (P < 0.001). The mean numeric rating scale score at rest at 6 h, on movement at 2 h and 6 h and satisfaction scores in Group P were significantly more than Group S. Conclusion: Ultrasound-guided SAP block provides better postoperative analgesia both in quality and duration over PEC II block. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus Disease-2019 (COVID-19) has taken the world by storm since its detection in China. The pandemic swept across the globe and affected India. The presence or absence of co-morbidities may determine the clinical outcome. Clinical manifestations include cough, fever and dyspnoea mainly. Aim: To elucidate epidemiological findings, clinical features, co-morbidities of COVID-19 disease and clinical outcomes in first 500 COVID-19 patients admitted at a tertiary care teaching hospital in Northern India. Materials and Methods: The retrospective observational study was conducted at Jawaharlal Nehru Medical College and Hospital (JNMCH), Aligarh Muslim University, Aligarh, Uttar Pradesh, India, from 21st April to 27th October 2020 on first 500 Reverse Transcription--Polymerase Chain Reaction (RT-PCR)/ Rapid Antigen or TruNatBeta positive patients. During January to March 2021 period data was collected and analysed. Data was analysed for epidemiological parameters, Symptoms and Clinical hospital outcomes of patients. Data was analysed using Statistical Package for the Social Sciences (SPSS) VERSION 21.0 IBM and p-value <0.05 was taken as significant. Results: Out of total patients, 284 (56.80%) and 216 (43.20%) were males and females respectively and 11.12% of females were pregnant. Difference in mean ages of males and females was significant (p-value<0.001). The results show that 434 patients (86.80%) recovered fully and were discharged (more males were discharged), whereas 47 (9.40%) patients died. Out of total 500 patients 75.60% patients stayed in the hospital for more than 72 hours and 24.40% stayed for less than 72 hours. The mean age of patients who stayed for less than 72 hours was 48.85± 17.93 as compared (44.23± 17.45) to those who stayed for more than 72 hours and the difference was significant (p-value=0.012). Most common symptom was fever (58%) followed by cough (32%) and dyspnoea (31%). The association between the duration of stay and clinical outcome was significant (p-value<0.001). Conclusion: Gender, advancing age, duration of stay and associated co-morbidities appear to play role in infection and outcome of COVID-19. [ABSTRACT FROM AUTHOR]

Background and Aims: Airway management is a key concern in trauma patients with cervical spine fracture. Application of manual inline axial stabilization (MIAS) has become the standard of care in these patients. Indirect laryngoscopy only requires alignment of the pharyngeal and laryngeal axis. Hence the primary objective of the study was to compare two indirect laryngoscopes, Airtraq (with adaptor) and Hansraj Video laryngoscopes based on its Intubation Difficulty Score. Material and Methods: Sixty anesthetized patients were divided into two groups using computer-based randomization, and tracheal intubation was performed using either Airtraq or Hansraj Videolaryngoscope with cervical spine immobilization. Results: Both Airtraq and Hansraj groups were comparable in terms of percentage of glottic opening (POGO) scoring (92 ± 9.88% vs. 89.3 ± 10.4%.) and duration of intubation attempt (14.9 ± 4.36 sec vs. 16.97 ± 3.64 sec). Intubation difficulty scale (IDS) score was significantly shorter with Airtraq (1 ± 0.58 vs. 1.8 ± 0.805; P < 0.0001). The mean duration of time taken for laryngoscopy in Airtraq (12.9 ± 2.07 s vs. 19.06 ± 3.83 s; P < 0.0001)) was significantly shorter and also the duration of time taken to secure airway in Airtraq VL was significantly shorter (29.47 ± 4.75 s vs. 36.03 ± 5.80 sec; P < 0.0001). The heart rate and MABP changes were modest in both groups, but was significantly more in Hansraj VL as compared to Airtraq VL, post-intubation. Conclusion: Both Airtraq and Hansraj videolaryngoscope can be used as first-hand device in the scenario of cervical spine stabilization. Airtraq videolaryngoscope is better than Hansraj videolaryngoscope due to shorter IDS and lessor hemodynamic changes. [ABSTRACT FROM AUTHOR]

Byline: Qazi. Ali, Syed. Amir, Obaid. Siddiqui, Shaista. Jamil Introduction Burns due to a variety of reasons are an important medico-social issue in developing countries, including India. Patients with chronic [...]

Byline: Qazi. Ali, Syed. Amir, Obaid. Siddiqui, Abu. Nadeem, Abdulla. Azhar Airway management in patients of ankylosing spondylitis remains a challenge for anaesthesiologists. Many new airway devices have been used [...]

Byline: Maulana. Ansari, Obaid. Siddiqui, Shahla. Haleem, Rohit. Varshney, Sadiq. Akhtar, Faroze. Khan Background: Post-operative nausea and vomiting (PONV) is common. 5HT [sub]3 receptor antagonists are commonly used drugs for [...]

This article is based on a review of around 100 western English print press articles recording rape in India. No cases were reported prior to the tragic and brutal rape of Nirbhaya in Delhi on the 16 December 2012. The article presents a critical analysis of the dominant discourses running through the articles and highlights the extent to which the colonial lens is still present as the main perspective through which India is viewed. The article highlights how press narratives are problematic for two main reasons. Firstly, because of the narrow reporting of only rape which suggests it occurs only to middle-class or modern urban women, the daily experiences of low-caste and Dalit women for example is ignored. Secondly, we identify the construction of a problematic-male who is labelled deviant, sexually feral and the key perpetrator of all rape violence in India. This article in no way denies the reality of violence against women in India, quite the contrary, but argues that the distorting imperialist picture emerging through the press does not support the work of feminist activists in India whose nuanced and complex understanding of the realities of violence must lead the way to eradicating it. [ABSTRACT FROM AUTHOR]

A reprint of the article "Rap Sheet: H. Rap Brown, Civil Rights Revolutionary--Cop Killer/FBI Target?" by Obaid H. Siddiqui, which appeared in the September 13, 2012 issue of "Illume," is presented. It features African American civil rights activist Jamil Abdullah Al-Amin, also known as H. Rap Brown. He was a popular activist who emboldened a generation of black youth in the 1960s. He is imprisoned at the Administrative Maximum Facility Penitentiary in Florence, Colorado.

A letter to the editor is presented about the use of stylet in airtraq optical laryngoscope for armored tube intubation.

Background and Objectives: Managing the airway of post burn contracture of the neck has always been challenging to anesthesiologists as it limits the alignment of oro-pharyngo-laryngeal axes because of functional and anatomical deformities that occur as a result of long standing contractures. Here the role of the King Vision video laryngoscope which is the latest in the series of video laryngoscope has been evaluated for such patients., Case Report: A 35 year old male patient with post burn contracture of neck was scheduled for release of the contracture. As the patient had had fixed flexion deformity of the neck we did not attempt the conventional laryngoscopy. Instead we opted for King Vision video laryngoscope., Conclusion: We therefore conclude that King Vision videolaryngoscope can be used for difficult airway situations like post burn contracture of neck., (Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.)

Background and Objectives: Lipoma is a progressively increasing disease which may appear anywhere in the body. Its appearance at the back of the neck, especially when it is large enough to cause restriction of neck extension, poses challenges to anesthesiologists in airway management whenever needed. This paper evaluates the role of Airtraq® in restricted neck movement., Case Report: Case with a huge lipoma of 14×12cm at the nape, and its surgical removal during an elective operation theatre posed difficulty in securing the airway by conventional laryngoscopy. To overcome the problem we successfully used a newly developed device, the Airtraq®, which is an optical laryngoscope for securing the airway., Conclusion: Airtraq® can be used for elective intubation in patients with restricted neck movements., (Copyright © 2012 Elsevier Editora Ltda. All rights reserved.)