Early clinical experience with a new video laryngoscope (SANYAR®) for tracheal intubation in adults: a comparison clinical study

Objective: SANYAR® video laryngoscope (S-VL) is a new video laryngoscope. We conducted a comparative clinical study to assess its ability to provide laryngeal exposure and facilitate endotrachetal intubation (ETI) in adult patients. Methods: This comparison clinical study was conducted on adult patients undergoing elective general anesthesia. The patients were randomly divided into two groups of direct laryngoscopy (DL) or S-VL. The primary outcome was the time required for performing ETI. The glottic view and successful ETI on the first attempt was also compared between the two groups. Results: Full and partial glottic visualization was achieved in 100% of the patients in the S-VL group, while the corresponding figure in the DL group was 90%. Cormack-Lehane III was observed in 5 patients of the DL group, and ETI was successfully carried out with S-VL. The first-pass success rate of ETI was significantly higher in S-VL group compared to the DL group (94% vs. 78%; P = 0.034). The mean times to ETI were 38.32±6.4 and 35.31±8.4 seconds in DL and S-VL groups, respectively (P = 0.650). Conclusions: During ETI for general anesthesia, SANYAR® video laryngoscope compared with direct laryngoscopy improved glottic visualization and first-pass ETI rate

The Efficacy of Intraoperative Ketamine-Haloperidol for Prevention of Catheter-related Bladder Discomfort After Lumbar Spinal Stenosis Surgery

Objectives: Catheterization of urinary bladder during surgery frequently leads to agitation of the patient in the recovery room, especially in those patients who remain catheterized after gaining consciousness. We hypothesized that administration of a combination of ketamine-haloperidol (KH) before urinary catheterization would reduce the incidence of catheter-related bladder discomfort (CRBD) while reducing some adverse effects of ketamine in the postoperative period. Methods: A total of 119 male patients who underwent lumbar spinal stenosis surgery were randomized into three groups. The KH group consisted of 39 patients who received KH just before urinary catheterization. The second arm of the study including 40 patients who received pethidine-haloperidol (PH). The control (C) group consisted of 40 patients who received normal saline as a placebo. We sought to determine the incidence and severity of CRBD at arrival in recovery and one, six, and 24 hours after. Results: The incidence of CRBD upon arrival in the recovery room was 17.9% in the KH group, and 52.5% and 55% in the PH and C groups, respectively. The incidence of CRBD was significantly lower in the KH group at arrival in the recovery room. The severity of CRBD was lower in the KH group at one and six hours of surgery (p < 0.007). There was no significant difference 24 hours after surgery. Conclusions: Intravenous administration of KH before urinary catheterization effectively decreases the incidence and severity of postoperative CRBD while reducing adverse effects attributed to ketamine

Evaluation of the Role of Hemoperfusion on Mortality and Morbidity in Patients with Severe Coronavirus Disease 2019 (COVID- 19)

Background: Cytokine storm in severe Covid-19 disease is one of the leading causes of death in these patients. Hemoperfusion is a method used to purify the blood from toxins and inflammatory factors. The aim of this study was to evaluate the effect of hemoperfusion on mortality and morbidity in patients with severe Covid - 19 disease. Methods: This was a retrospective study which performed by reviewing the files of 30 patients with severe Covid-19 disease referred to Sina Hospital affiliated to Tehran University of Medical Sciences in 2020. Thirty patients with severe covid-19 disease and positive PCR participated in the study. All patients received routine treatment protocol for covid-19. Hemoperfusion was used for 15 patients in addition to receiving routine care. The remaining 15 patients were included in the control group. Patients in the hemoperfusion group underwent four sessions of hemoperfusion using continuous renal replacement therapy with continuous venovenous hemofiltration. Results: the ICU length of stay in the control and hemoperfusion groups was 3.40 ± 11.40 and 9.65 ± 16.33 days, respectively (P= 0.075). 8 patients died and 7 patients were discharged in the control group, but 11 patients died and 4 patients were discharged in the hemoperfusion group (P= 0.256). The respiratory rate of patients in the control and hemoperfusion groups decreased from 7.43 ± 29.40 to 4.03 ± 24.60 and from 6.11 ± 31.60 to 5.04 ± 24.46, respectively (P < 0.001). The percentage of arterial blood oxygen saturation in the control and hemoperfusion groups increased from 90.86 ± 5.61 to 93.06 30 4.30 and from 92.33 26 3.26 to 92.06 31 5.31, respectively (P= 0.456). Conclusion: Hemoperfusion could not prevent the mortality of patients and finally out of 15 patients, 11 patients died and 4 patients were discharged. Also, no significant difference was observed between the two groups in terms of arterial blood oxygen saturation

Étude des stratégies linguistiques de locuteurs de français L1 et d'apprenants étrangers lors de la prise de notes en français : perspectives en didactique des langues

Cette thèse se propose d’étudier les différents types de traitement utilisés par des locuteurs de français L1 et des apprenants étrangers de français lors de la prise de notes dans cette langue, à partir du discours oral magistral. Ce travail qui s’inscrit dans une perspective psycholinguistique vise à analyser la conformité et la fidélité sémantique et formelle des textes-cibles (les productions) par rapport au texte-source (le discours émis). Le cadre théorique de la thèse analyse différentes approches et taxinomies relatives aux stratégies communicatives en langue étrangère, notamment celle de Kellerman, dans le but de dégager une typologie des stratégies de traitement à étudier dans les données empiriques relevées. Afin d’étudier l’efficacité des prises de notes des participants à l’enquête observés, nous avons conçu une grille d’analyse intitulée une « grille de matrices » permettant d’analyser d’une part, le discours professoral (par la méthode de l’analyse discursive de Van Dijk) et d’identifier et de quantifier différents procédés audiographiques déployés par les noteurs observés. A l’issue d’analyses portant sur la forme et le fond des textes recueillis, nous avons dégagé des résultats détaillés relatifs à l’efficacité de la prise de notes des participants observés. Au terme des analyses, des propositions didactiques en matière de prise de notes en langue maternelle et étrangère sont formulées.This thesis intends to study different types of treatments used by speakers of French L1 and foreign learners of French for note-taking during an oral lecture in that language. From a psycholinguistic perspective, this assignment aims to analyze compliance and definite semantic fidelity of targets-texts (productions) in comparison with the source-text (the issued speech). The theoretical context of the thesis analyzes different approaches and taxonomies relating to conversational strategies in a foreign language notably that of Kellerman, with the intention of identifying a typology of treatment strategies to be studied in gathered empirical data. To study the effectiveness of the participants’ note-taking, we conceived an analysis grid called “matrix grid” allowing to analyze, on one hand, professorial speech (through the method of the discursive analysis of Van Dijk) and on the other hand, to identify and quantify different audiographique techniques used by examined note takers. After analyzing the form and semantic content of the gathered texts, we formulated detailed results relating to the effectiveness of the examined participants’ note-taking. As a consequence of these analyses, didactic proposals in note-taking in a native or foreign language were formulated

Étude des stratégies linguistiques de locuteurs de français L1 et d'apprenants étrangers lors de la prise de notes en français (perspectives en didactique des langues)

Cette thèse se propose d étudier les différents types de traitement utilisés par des locuteurs de français L1 et des apprenants étrangers de français lors de la prise de notes dans cette langue, à partir du discours oral magistral. Ce travail qui s inscrit dans une perspective psycholinguistique vise à analyser la conformité et la fidélité sémantique et formelle des textes-cibles (les productions) par rapport au texte-source (le discours émis). Le cadre théorique de la thèse analyse différentes approches et taxinomies relatives aux stratégies communicatives en langue étrangère, notamment celle de Kellerman, dans le but de dégager une typologie des stratégies de traitement à étudier dans les données empiriques relevées. Afin d étudier l efficacité des prises de notes des participants à l enquête observés, nous avons conçu une grille d analyse intitulée une grille de matrices permettant d analyser d une part, le discours professoral (par la méthode de l analyse discursive de Van Dijk) et d identifier et de quantifier différents procédés audiographiques déployés par les noteurs observés. A l issue d analyses portant sur la forme et le fond des textes recueillis, nous avons dégagé des résultats détaillés relatifs à l efficacité de la prise de notes des participants observés. Au terme des analyses, des propositions didactiques en matière de prise de notes en langue maternelle et étrangère sont formulées.This thesis intends to study different types of treatments used by speakers of French L1 and foreign learners of French for note-taking during an oral lecture in that language. From a psycholinguistic perspective, this assignment aims to analyze compliance and definite semantic fidelity of targets-texts (productions) in comparison with the source-text (the issued speech). The theoretical context of the thesis analyzes different approaches and taxonomies relating to conversational strategies in a foreign language notably that of Kellerman, with the intention of identifying a typology of treatment strategies to be studied in gathered empirical data. To study the effectiveness of the participants note-taking, we conceived an analysis grid called matrix grid allowing to analyze, on one hand, professorial speech (through the method of the discursive analysis of Van Dijk) and on the other hand, to identify and quantify different audiographique techniques used by examined note takers. After analyzing the form and semantic content of the gathered texts, we formulated detailed results relating to the effectiveness of the examined participants note-taking. As a consequence of these analyses, didactic proposals in note-taking in a native or foreign language were formulated.AIX-MARSEILLE1-Bib.electronique (130559902) / SudocSudocFranceF

Inadvertent intrathecal injection of large dose magnesium sulfate

The case is a 35-year-old man who underwent spinal anesthesia for emergency strangulated inguinal hernia repair. About five minutes after 3 ml intrathecal drug injection, the patient suffered respiratory distress, bradycardia, hypotension and loss of consciousness. The patient was rapidly intubated and crystalloid infusion and epinephrine drip were established. Thereafter, he was admitted in intensive care unit. Search for the cause revealed us that 3 ml of magnesium sulfate (50%) was injected mistakenly for spinal anesthesia. Two days later, he was extubated and on the fifth day, he was discharged from the hospital without an obvious evidence of complication

Post Dural Puncture Headache after Cesarean Section, a Teaching Hospital Experience

Objective: This prospective study examined the frequency of Post-Dural Puncture Headache (PDPH) in 361 parturient women undergoing spinal anesthesia for cesarean section in a teaching hospital of Tehran University of Medical Sciences. Materials and methods: Spinal anesthesia was performed using 25 gauge Quincke needles in all women. Patients were followed up to determine incidence of PDPH and then tried to compare those with or without PDPH using statistical methods to determine risk factors of PDPH. Results: The overall incidence of PDPH was 10.8 percent in this study. In terms of probable risk factors which were compared between the two groups of patients, no statistically significant differences were found. Conclusion: The incidence of PDPH in our study was higher than studies which used pencil - tipped needles and we determined that the occurrence of PDPH is not associated to some factors like the previous history of nonspecific headache, Body Mass Index, age, type of local anesthetic, previous history of PDPH, experience of operator, history of habitual tea and coffee drinking

Comparison of aPTT and CT Parameter of the ROTEM Test to Monitor Heparin Anti-Coagulation Effect in ICU Patients: an Observational Study

Heparin is frequently used in different clinical settings to reduce the coagulating ability of the blood. Because of probable adverse effects owing to heparin therapy and regarding variability of patients’ responses to heparin, which make it very unreliable, it seems prudent to monitor meticulously its effects on the human body. There are a lot of laboratory tests to watch its effects on the body for example; aPTT and ROTEM are the most widely used tests that are performed today. We aimed to compare the aPTT test results against changes of CT parameter of the ROTEM test due to heparin administration. This study was conducted on 45 critically ill patients who needed to receive heparin according to their clinical status. All patients received 550 to 1500 unit heparin per hour (on average 17.5 unit heparin per kilogram weight). While the patients were under infusion of heparin, two blood samples (5 ml) were taken from a newly established cubital vein, just five hours after commencement of heparin therapy. One sample was used for aPTT and the other one for ROTEM. The correlation between aPTT and the changes of CT parameter of the ROTEM with heparin dosage and infusion was the primary outcome. The correlation between heparin therapy and the changes of other parameters like MCF, CFT, and a number of platelets were the secondary outcome of the study. The only significant correlation was between changes of CT and aPTT (P=0.000). The other variables were not correlated. Changes of CT parameter of ROTEM test can be used for monitoring of reduced coagulability during heparin infusion instead of aPTT test

Effects of normal saline vs. lactated ringer's during renal transplantation

Aim. We hypothesized that normal saline (NS) may have more deleterious effects compared with lactated ringer (LR) in kidney transplant recipients because of the higher risk of acidosis and higher levels of serum potassium. Thus, the aim of this study was to determine the safety of LR if used during a renal transplant. Methods. Adults undergoing kidney transplantations were enrolled in a double-blinded randomized prospective clinical trial. They were divided into two groups in order to receive NS and LR infusion as intraoperative IV fluid replacement therapy. Results. There was a significant difference in the serum potassium level (p = .000) and the PH (p = .007) between the two groups at the end of transplantations. Two patients in the LR group lost their kidneys due to vascular graft thrombosis. In other words, hyperkalemia and acidosis occurred more frequently in the NS group while thrombotic events may be of concern in the LR group. Conclusion. Compared with NS, LR infusion may lead to a lower serum potassium level and a lower risk of acidosis, while there is major concern of the hypercoagulable state in these patients