An analytical study of standard propofol- sufentanil target controlled infusion protocols for total intravenous anaesthesia requirements in an Indian population using bispectral index monitoring

Background: Target controlled infusion (TCI) is an automated and regulated total intravenous anaesthesia delivering device. On the basis of western pharmacokinetic and pharmacodynamic models it delivers a calculated dosage of intravenous anaesthetic drugs to achieve an ideal anaesthetic plane. The depth of anaesthesia is judged by monitors such as bispectral index (BIS) monitors which gives a rough estimate whether the TCI is delivering more or less.Methods: This analytical study was carried out on 100 patients between 20 to 60 years of age in a teaching hospital. Simultaneous BIS monitoring and TCI were set on these patients. If BIS values went below 45 the target concentration was decreased by 0.5μg/ml and if it was more than Injection propofol was supplemented manually and the changes were collected and analyzed.Results: On analyses and comparison of the data with a western study it was found that the duration of surgery was similar in both studies. With the help of “t” test based on normal distribution it was found that group having BIS 60 was more statistically significant in the Indian population.Conclusions: Depth of anaesthesia was assessed with neurological monitor, BIS, at the time of administration of Target controlled infusion (TCI) and data acquired was compared with data from a western study. The two groups had similar anaesthetic depth levels with the same infusion protocols of Target controlled infusion (TCI)

Effect of obesity and metabolic syndrome on severity, quality of life, sleep quality and inflammatory markers in patients of asthma in India

Introduction: The study aimed to compare the effect of obesity with and without metabolic syndrome on asthma severity, quality of life, sleep quality, sleep disordered breathing and inflammatory markers as compared to non-obese asthma patients. Material and methods: 60 asthma patients recruited for the study were divided equally into non-obese (NOA), obese without metabolic syndrome (OANMS) and obese with metabolic syndrome (OAMS) groups. Study cohorts were assessed for severity of asthma, quality of life and quality of sleep using questionnaires and inflammatory markers (FENO, hs-CRP, IL-5, IL-6 and leptin). Institutional ethical committee approved the study. Results: The results suggests OAMS patients may be a subtype of asthmatics having significantly severe asthma (p < 0.05), poor quality of life (p < 0.05), high risk of OSA (p < 0.05), decreased lung volumes (FRC) (p < 0.05), higher levels of inflammatory markers (leptin and IL-6) (p < 0.05), and high incidence of sleep disordered breathing (p < 0.05) in comparison to NOA and OANMS patients. Conclusions: The present study has shown that obese asthmatics especially with metabolic syndrome represent a subtype of asthmatic population. Hence, the treatment of metabolic syndrome may be necessary in addition to asthma to achieve optimal control.  INTRODUCTION: The study aimed to compare the effect of obesity with and without metabolic syndrome on asthma severity, quality of life, sleep quality, sleep disordered breathing and inflammatory markers as compared to non-obese asthma patients. MATERIAL AND METHODS: 60 asthma patients recruited for the study were divided equally into non-obese (NOA), obese without metabolic syndrome (OANMS) and obese with metabolic syndrome (OAMS) groups. Study cohorts were assessed for severity of asthma, quality of life and quality of sleep using questionnaires and inflammatory markers (FENO, hs-CRP, IL-5, IL-6 and leptin). Institutional ethical committee approved the study. RESULTS: The results suggests OAMS patients may be a subtype of asthmatics having significantly severe asthma (p < 0.05), poor quality of life (p  < 0.05), high risk of OSA (p < 0.05), decreased lung volumes (FRC) (p < 0.05), higher levels of inflammatory markers (leptin and IL-6) (p  < 0.05), and high incidence of sleep disordered breathing (p < 0.05) in comparison to NOA and OANMS patients. CONCLUSIONS: The present study has shown that obese asthmatics especially with metabolic syndrome represent a subtype of asthmatic population. Hence, the treatment of metabolic syndrome may be necessary in addition to asthma to achieve optimal control.

Spectrum of interstitial lung disease at a tertiary care centre in India

Introduction: The available data on the epidemiology of interstitial lung disease (ILD) from India is sparse. Hence, the present study was undertaken with the aim to analyse the demographic profile and clinical, radiological and pathological characteristics along with physiological parameters of various subgroups of ILD patients.Material and methods: We retrospectively studied 289 patients diagnosed with ILD during the years 2001–2013 at one of the respiratory units of Vallabhbhai Patel Chest Institute.Results: Mean age at presentation was 44.24 years; females comprised 54.68% of the patients. Prior to presentation at our centre, 14.84% patients had been treated with antituberculous therapy due to misdiagnosis of tuberculosis. In the pool of ILDs analysed, sarcoidosis (37.3%) was found to be the most common subgroup, followed by IPF (27.6%) and NSIP (25.6%). Cough (92.97%) was the most common presenting symptom; exertional dyspnoea was found in 79.2% of patients. Digital clubbing was commonest in IPF, found in 30% of patients. Significant desaturation on six-minute walk test was most frequenty seen (50%) in NSIP patients. The most common pattern on chest roentgenogram was reticular/reticulo-nodular pattern (80.2%) and on HRCT — interstitial fibrosis (49.9%). Mean of predicted total lung capacity (TLC) was 64.3%, the lowest being in the IPF group (58.88%). Mean of predicted DLCO was 50.56%, the lowest being in the IPF group (42.75%). The overall diagnostic yield of bronchoscopic biopsy was 83.04%, the highest yield being among sarcoidosis patients (96.29%).Conclusions: We found sarcoidosis, IPF and NSIP to be the most common ILDs in northern India. ILDs are still frequently misdiagnosed as TB, and increased awareness, education and diagnostic facilities are required to diagnose ILDs at an early stage.Wstęp: Istnieje stosunkowo mało informacji dotyczących epidemiologii śródmiąższowych chorób płuc (ILD) w Indiach. Aktualna praca została podjęta w celu oceny danych demograficznych, kliniczno-patologicznych i fizjologicznych różnych typów chorób śródmiąższowych.Materiał i metody: Badaniem retrospektywnym objęto 289 pacjentów, u których rozpoznano ILD w latach 2001–2013 w jednym z oddziałów Vallabhbhai Patel Chest Institute (Indie, Delhi).Wyniki: Średni wiek chorych w chwili rozpoznania wynosił 44,4 roku, kobiety stanowiły 54,68% ogółu chorych. Z powodu mylnego rozpoznania gruźlicy 14,84% chorych było uprzednio leczonych przeciwprątkowo. Sarkoidozę rozpoznano u 37% chorych, a IPF i NSIP odpowiednio w przypadku 27,6 i 25,6% chorych. Najczęściej zgłaszanymi objawami były kaszel (92,97%) i duszność wysiłkowa (79,2%) a palce pałeczkowate stwierdzono u 30% chorych na IPF. Znamienny spadek utlenowania krwi w 6-minutowym teście chodu najczęściej obserwowano u chorych na NSIP (50%). Zmiany guzkowo-siateczkowe w obrazie radiologicznym uwidoczniono u 80,2% chorych, a śródmiąższowe włóknienie w badaniu HRCT wykryto u 49,9% chorych. Średnia wartość zdolności dyfuzyjnej płuc (DLCO) wynosiła 50,56% wartości należnej i była najbardziej upośledzona w grupie chorych na IPF (42,75%). Wartość diagnostyczna biopsji wykonanej podczas bronchoskopii wynosiła 83,04% i dotyczyła szczególnie chorych na sarkoidozę (96,29%).Wnioski: Autorzy pracy stwierdzili, że w północnych Indiach najczęstszymi chorobami śródmiąższowymi są: sarkoidoza, IPF i NSIP. Śródmiąższowe choroby płuc są w Indiach często rozpoznawane błędnie jako gruźlica, dlatego konieczne jest szkolenie personelu i stworzenie ułatwień diagnostycznych, aby były one trafnie rozpoznane we wczesnym stadium

Antidiarrheal pill in the airway

Pill aspiration depicts an unusual type of foreign body aspiration necessitating a discrete diagnostic and therapeutic approach.1 Some pills may remain intact in the endobronchial tree for many years without causing much harm, whereas others may dissolve2 The clinical outcomes may also vary, from an asymptomatic granuloma to severe, life-threatening airway complications, depending upon the chemical properties of the pill. We report a compelling case of pill aspiration in a healthy patient.

Edge Enhancement from Low-Light Image by Convolutional Neural Network and Sigmoid Function

Due to camera resolution or any lighting condition, captured image are generally over-exposed or under-exposed conditions. So, there is need of some enhancement techniques that improvise these artifacts from recorded pictures or images. So, the objective of image enhancement and adjustment techniques is to improve the quality and characteristics of an image. In general terms, the enhancement of image distorts the original numerical values of an image. Therefore, it is required to design such enhancement technique that do not compromise with the quality of the image. The optimization of the image extracts the characteristics of the image instead of restoring the degraded image. The improvement of the image involves the degraded image processing and the improvement of its visual aspect. A lot of research has been done to improve the image. Many research works have been done in this field. One among them is deep learning. Most of the existing contrast enhancement methods, adjust the tone curve to correct the contrast of an input image but doesn’t work efficiently due to limited amount of information contained in a single image. In this research, the CNN with edge adjustment is proposed. By applying CNN with Edge adjustment technique, the input low contrast images are capable to adapt according to high quality enhancement. The result analysis shows that the developed technique significantly advantages over existing methods

Business Plan of Precious Pets

Precious Pets is a one stop shop for all the dog lovers and pet owners in India. It not only breeds and sells pedigree dogs in its facility but also provides all the related products and services under the same roof as well

Lifestyle factors and asthma in India — a case-control study

INTRODUCTION: There has been a recent trend of increasing prevalence of asthma in developing countries; prevalence in the Indian population is reported to be 2%. The link between lifestyle factors and asthma has been mostly derived from western literature. The present study intended to study relationship if any, between life style factors and asthma in a representative Indian population. MATERIAL AND METHODS: The study is a case-control study performed for a period of one year, between 2014 and 2015. 125 asthma and correspondingly age and sex matched healthy controls were recruited for the purpose of study. A self-reported questionnaire has been prepared based on routine lifestyle habits of Indian population. RESULTS: The hours of TV watching and hours of sleep were significantly higher in asthma patients, and also duration of sports activity showed inverse relation with asthma. Smoking, tobacco, chewing as well as alcohol consumption were higher in asthma patients in comparison to controls, though neither was statistically significant. The mental stress as assessed on scale of 1−10, was significantly higher in asthma patients (p < 0.001). Asthma patients had significantly lower travel duration/week (p < 0.05). CONCLUSION: The present study concluded increased TV watching, increased mental stress, reduced hours of physical activity and travel may be correlated with asthma in India. With growing evidence of increasing association of asthma and sedentary lifestyle, it is imperative to reduce acquaintance to as well as incidence of these factors through public health policies, which may impact prevalence of asthma in Indian population.INTRODUCTION: There has been a recent trend of increasing prevalence of asthma in developing countries; prevalence in the Indian population is reported to be 2%. The link between lifestyle factors and asthma has been mostly derived from western literature. The present study intended to study relationship if any, between life style factors and asthma in a representative Indian population. MATERIAL AND METHODS: The study is a case-control study performed for a period of one year, between 2014 and 2015. 125 asthma and correspondingly age and sex matched healthy controls were recruited for the purpose of study. A self-reported questionnaire has been prepared based on routine lifestyle habits of Indian population. RESULTS: The hours of TV watching and hours of sleep were significantly higher in asthma patients, and also duration of sports activity showed inverse relation with asthma. Smoking, tobacco, chewing as well as alcohol consumption were higher in asthma patients in comparison to controls, though neither was statistically significant. The mental stress as assessed on scale of 1−10, was significantly higher in asthma patients (p < 0.001). Asthma patients had significantly lower travel duration/week (p < 0.05). CONCLUSION: The present study concluded increased TV watching, increased mental stress, reduced hours of physical activity and travel may be correlated with asthma in India. With growing evidence of increasing association of asthma and sedentary lifestyle, it is imperative to reduce acquaintance to as well as incidence of these factors through public health policies, which may impact prevalence of asthma in Indian population