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Evaluation of effect of lung recruitment manoeuvres on perioperative atelectasis in laproscopic cholecystectomies: a randomised controlled trial.

Sat, 01 Jan 2022 00:00:00 GMT

Title: Evaluation of effect of lung recruitment manoeuvres on perioperative atelectasis in laproscopic cholecystectomies: a randomised controlled trial. Authors: Apurva Kumari Abstract: BACKGROUND: Approximately 90% of patients undergoing general anesthesia encounter atelectasis, especially after laparoscopic cholecystectomy. Pneumoperitoneum during laparoscopic surgeries significantly hinders pulmonary function, leading to notable atelectasis. The lung recruitment maneuver may mitigate hypoxia caused by atelectasis and minimize postoperative pulmonary complications. METHODS: Patient selection was randomized; Group UC did not receive lung recruitment, while Group URM did. All patients underwent ultrasonography at four time points: T1 - just before anaesthesia induction, T2 - post-surgery, T3 - 15 minutes post-extubation, and T4 - 30 minutes post-extubation. Only participants from the URM group received lung recruitment, which was guided by real-time ultrasound. Ultrasonic scanning indicated the absence of collapsed areas following manual adjustment of airway pressure from 10 cmH2O to 20 cmH2O, with a FiO2 of 0.4. Every patient received lung ultrasonography at 15 (T3) and 30 (T4) minutes following extubation to evaluate persistent atelectrauma and desaturation. CONCLUSION: At T3 and T4, the URM group exhibited a significantly reduced aeration loss of 22% and 51%, respectively, when compared to the UC group, which showed losses of 53% and 87% (p < 0.01). The URM group exhibited better oxygenation post-surgery compared to the UC group, with mean SpO₂ values of 98.10 ± 1.744% versus 94.54 ± 1.286% (p = 0.001). The increased alveolar recruitment and gas exchange in the URM group accounted for this outcome. In conclusion, the utilization of ultrasound for facilitating lung recruitment techniques may decrease atelectasis during surgeries, improve oxygenation, and result in enhanced pulmonary outcomes in laparoscopic cholecystectomy.

Relationship between serum magnesium levels and insulin resistance in overweight children

Fri, 01 Jan 2021 00:00:00 GMT

Title: Relationship between serum magnesium levels and insulin resistance in overweight children Authors: Gadiparthi, Sowmya Abstract: Background: This cross-sectional case-control study aimed to explore the relationship between serum magnesium levels and insulin resistance in children with overweight or obesity. Methodology: At Shri B M Patil Medical College Hospital, this 1.5-year cross-sectional case-control investigation investigated the association among levels of magnesium in the blood and insulin resistance in children aged 5 to 16. Cases met the 2015 revised IAP growth charts for overweight or obesity, in comparison to age-matched healthy controls. Exclusions included secondary causes of obesity and medical complications affecting magnesium. Assessments involved clinical history, examination, and fasting blood tests for insulin resistance indices. The study aimed for a total sample size of 110 participants, utilizing G*Power software. Results: Overweight children exhibited significantly lower mean serum magnesium levels compared to controls (1.03 mEq/l vs. 1.85 mEq/l, p < 0.001). Anthropometric measures, including BMI and percentage body fat, were significantly higher in cases. Metabolic markers, such as fasting insulin, HOMA, and lipid profiles, also demonstrated substantial differences. Systolic blood pressure, while not significantly different, displayed a trend towards elevation in overweight children. Conclusion: This finding underscores the potential relevance of magnesium in the context of childhood obesity and its metabolic consequences.

Socio demographic and psychological factors associated with human milk donation in vijayapura

Fri, 01 Jan 2021 00:00:00 GMT

Title: Socio demographic and psychological factors associated with human milk donation in vijayapura Authors: Bodi jayakrishna, vasudha Abstract: Introduction: INTRODUCTION Breast feeding is the best and quintessential method for infant nutrition, providing essential nutrients and immunological protection. All mothers should be encouraged to breast feed their infants, but is not always feasible for all mothers due to various barriers. If mother’s own milk is unavailable or insufficient, the next best option is to use donated human milk (DHM). Human milk banking (HMB) serves as a crucial intervention, ensuring that infants unable to receive direct breastfeeding can still benefit from the properties of human milk. This study aims to understand the factors influencing the willingness to donate breast milk among lactating mothers in Vijayapura, India. Objectives: To obtain information on knowledge and attitude in mothers of urban and rural groups and to determine awareness factors for milk bank donation and also to compare responses in different socio demographic factors. Methods: Type of study: Cross Sectional Study Study period: Period of 20 months, July 2022 to March 2024 Study population: All hospitalized lactating mothers of Shri BM Patil Medical College Hospital and research Centre, Vijayapura who met the inclusion Criteria. Methodology: A cross-sectional study was conducted by department of pediatrics at Shri BM Patil Medical College Hospital and Research Centre. The study included hospital-based lactating mothers who were selected through convenience sampling. Data was collected via face-to-face interviews using a semi-standardized questionnaire designed to capture socio-demographic details, maternal factors, and knowledge and attitudes towards milk bank donation. The questionnaire included variables such as age, residence, education, marital status, income, obstetric history, mode of delivery, breastfeeding counseling, and current breastfeeding status. Statistical analysis Data of 420 lactating mothers were entered into Microsoft Excel and analyzed using SPSS Version 20. Descriptive statistics, inferential statistics, including logistic regression analysis identified socio-demographic and knowledge factors associated with the willingness to donate breast milk, calculating crude and adjusted odds ratios with 95% confidence intervals. Results: Among the 420 participants, 50% were from urban and 50% from rural areas. Significant predictors of willingness to donate breast milk included urban residence (AOR: 2.01, 95% CI: 1.30–2.96), higher education levels (Bachelor’s degree: AOR: 2.57, 95% CI: 1.11–8.42; Master’s degree: AOR: 6.13, 95% CI: 1.28–34.37), multigravida (AOR: 2.65, 95% CI: 1.74–4.04), normal vaginal delivery (AOR: 1.88, 95% CI: 1.15–2.88), previous knowledge about milk donation (AOR: 7.56, 95% CI: 3.73–15.8), and a history of NICU admissions for the present (AOR: 1.77, 95% CI: 1.15–2.96) or previous baby (AOR: 8.46, 95% CI: 2.84–12.46).Conclusion: Urban residence, higher education levels, multi-parity, normal vaginal delivery, prior knowledge of milk donation, and history of NICU admissions are key predictors of willingness to donate breast milk. Targeted interventions are needed to bridge the gap in knowledge and promote milk donation, ultimately improving neonatal health outcomes in both urban and rural settings.

Lung ultrasonography score to evaluate oxygenation and surfactant need in neonates treated with respiratory support

Fri, 01 Jan 2021 00:00:00 GMT

Title: Lung ultrasonography score to evaluate oxygenation and surfactant need in neonates treated with respiratory support Authors: Apoorva gayatri, abbadi Abstract: Background: Lung ultrasonography (LUS) has emerged as a radiation-free alternative to chest X-rays, showing promise in assessing lung aeration and guiding therapeutic decisions in neonates with respiratory distress. Despite its potential, widespread adoption of LUS requires standardized protocols and further validation against traditional imaging modalities like CXRs. Aim This study aimed to evaluate the effectiveness of Lung Ultrasonography Score (LUS) in assessing oxygenation levels and identifying the need for surfactant therapy in neonates receiving respiratory support at a Level IIB Neonatal Intensive Care Unit (NICU). Methodology: This prospective observational study was conducted from January 2021 to June 2022 at a Level IIB Neonatal Intensive Care Unit (NICU) in Karnataka, India. The study included neonates <34 weeks and >34 weeks gestational age admitted with respiratory distress, excluding those with chromosomal abnormalities or congenital lung diseases. Lung ultrasonography scores (LUS) were assessed upon admission and before surfactant administration, using a scoring system ranging from 0 to 3 across defined thoracic regions to evaluate lung aeration. Statistical analysis included correlation tests and ROC curve analysis to assess LUS's ability to predict oxygenation parameters and need for surfactant therapy. Results: A total of 75 neonates were included in the study, with mean LUS scores correlating significantly with arterial to alveolar ratios (r = -0.74, p < 0.001) and PaO2 values (r = 0.68, p < 0.001). LUS demonstrated good predictive accuracy for surfactant therapy need, with an areaunder the ROC curve of 0.85 (95% CI: 0.75-0.95). Neonates requiring surfactant therapy had significantly higher mean LUS scores compared to those managed conservatively (p < 0.001). Conclusion: These findings underscore the utility of LUS in assessing lung aeration and guiding clinical management decisions in neonates with respiratory distress, potentially enhancing early intervention strategies in NICU settings.