A comparative study to assess I-gel as an alternative to endotracheal tube in laparoscopic surgeries

Background: This study was conducted to compare and evaluate the effectiveness of I-gel over endotracheal tube with regards to respiratory and  hemodynamic parameters  in laproscopic surgeries. Methods: In this study 60 adult patients of either sex, of ASA status I or II, aged 16 to 60 years, undergoing laparoscopic surgeries under general anesthesia were randomly studied. In Group-A (I-gel) appropriate sized I-gel was inserted, and in Group-B (ETT) patient’s airway was secured with laryngoscopy-guided endotracheal intubation. Monitoring of PR, MBP, SpO2 and EtCO2 was done throughout the peri-operative period. Haemodynamic and ventilatory parameters were recorded before induction (baseline), just after intubation, then at 1, 3 and 5 min after I-gel insertion/intubation, after pneumoperitoneum, after change of position, before and 5 min after release of pneumoperitoneum and after I-gel removal/extubation. Results: Following the insertion of airway device there was significant rise in PR (3 min after intubation [P = 0.011, df-58, CI-95%]) and MBP (3 min after intubation [P = 0.02, df-58, CI-95%], 5 min after intubation [P = 0.04, df-58, CI-95%]) in Group-B patients when compared to Group-A patients. Following insertion of airway device there was no significant difference in EtCO2 (3 min after intubation [P = 0.778, df-58, CI-95%]), 5 min after intubation [P = 0.75, df-58, CI-95%]) in Group-B patients when compared to Group-A patients. Conclusions: I-gel requires less time for insertion with minimal haemodynamic changes when compared to ETT. I-gel can be a safe and suitable alternative to ETT for laparoscopic surgery

Pattern of renal and urinary tract disorders in children

Background: Pediatricians encounter a wide spectrum of renal and urinary tract ailments in children most of which cause considerable morbidity and mortality in children. Such disorders are seen in children of all age groups starting right from infancy up till adolescence. The aim of our study was to study the prevalence, spectrum and clinical profile of such disorders in children. Methods: This was a hospital based prospective observational study conducted over a period of 12 months from September 2017 to September 2018 at G. B. Pant hospital and Sher-i-Kashmir Institute of Medical Sciences Srinagar. Children presenting with renal and urinary tract disorders between the age group of 1 month and 12 years were prospectively observed and recorded. Results: Total number of patients between age group 1month to 12 years admitted with renal and urinary tract disorders were 197. Majority of patients i.e. 56 (28.4%) were less than one year old. Mean±SD age of patients was 3.9±3.41 years. Fever was the most common complaint present in 78 patients (39.6%).  Urinary tract infection was the most common diagnosis in our study comprising of 71 (36%) patients followed by nephrotic syndrome in 39 (19.8%). Other diagnosis were congenital anomalies of kidney and urinary tract- CAKUT (13.2%), acute glomerulonephritis-AGN (10.2%), Acute kidney injury- AKI (9.1%), chronic kidney disease- CKD in 9 (4.6%) and tubular disorders (4.1%). Conclusions: Because of their significant prevalence and impact on the quality of life, renal and urinary tract disorders require prompt diagnosis and management because early detection and treatment improves the morbidity and mortality