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Introduction Indirect laryngoscopy has become a widely accepted method for learning the techniques of airway management. The incorporation of small, less expensive, and yet more reliable video cameras in laryngoscopes has given the process of laryngoscopy and intubation a big leap. The King Vision video laryngoscope (Medline Industries, USA) has demonstrated promise in several settings while the Linscope video laryngoscope (Centrum, Turkey) is a newly launched device and no literature is available to the best of our knowledge. Therefore, we aimed to compare the performance of the Linscope video laryngoscope (VL) and King Vision video laryngoscope. Method This is a randomized controlled trial study. Seventy patients, after approval from the institute's ethical clearance, were divided into two groups. In Group A, patients were intubated with Linscope VL and in Group B patients were intubated with King Vision VL as per the protocol. The primary outcome measure was the duration of tracheal intubation. Secondary outcomes were measured by the number of attempts, ease of intubation, and glottic view. Results Both Linscope VL and King Vision VL groups were comparable in terms of mean intubation time (20.34 s vs. 19.45 s). The endotracheal intubation with both devices was 100% successful at the first attempt. Both the devices provided a percentage of glottic opening (POGO) score of > 70% and a clear vision of the glottis. The POGO score obtained with King Vision VL was 83.57 ± 11.41% and with Linscope VL was 87.85 ± 10.31%. POGO score was greater with Linscope VL compared to King Vision VL, but the difference was not statistically significant (p-value>0.05). Conclusion King Vision demonstrated shorter intubation time and fewer optimization maneuvers. Both devices achieved a 100% success rate on the first attempt. While both devices are viable first-line options, King Vision's well-established efficacy in the literature suggests its preference over Linscope till extensive evidence is available in the future.
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INTRODUCTION: Type 1 diabetes mellitus (T1DM) is frequently associated with other autoimmune disorders that are characterized by the presence of organ-specific autoantibodies. Autoimmune thyroid disease (AIT) is the most frequent autoimmune disorder associated with T1DM. Thyroid peroxidase antibodies (TPOAb) serve as a marker for diagnosing AIT. Prior research indicates that thyroid dysfunction can negatively impact linear growth and glycemic control in subjects with T1DM. The present study was done to determine the impact of thyroid autoimmunity on the clinical and biochemical characteristics of patients with newly diagnosed T1DM. METHODS: In this single-center, hospital-based, observational cross-sectional study, we enrolled 70 patients with newly diagnosed T1DM ≤18 years of age. Type 1 diabetes mellitus was diagnosed based on the acute onset of osmotic symptoms with or without diabetic ketoacidosis (DKA), severe hyperglycemia (blood glucose >13.9 mmol/l (>250 mg/dl)), and insulin requirement from the onset of diabetes. Secondary diabetes, pancreatic diabetes (Type 3c), and maturity-onset diabetes of the young (MODY) were excluded. Participants were screened for AIT disease using TPOAb testing. Based on the presence or absence of TPOAb, the participants were categorized into two groups: Group A comprised individuals with T1DM who tested positive for TPOAb, while Group B consisted of those who tested negative for TPOAb. RESULTS: Out of 70 patients, 41.4% were girls and 58.6% were boys, with a mean age of 9.8±4.4 years. The prevalence of TPOAb among the cohort was 18.6%. A significant majority of patients (71.4%), presented with DKA. Group A showed significantly lower mean height standard deviation scores (SDS) compared to Group B (-0.3±0.6 vs. -0.8±0.5, p = 0.004), but no differences in weight SDS or BMI SDS. Hemoglobin A1C (HbA1c) levels, C-peptide levels, and frequency of DKA did not differ between groups. Group A had higher mean thyroid-stimulating hormone (TSH) levels (4.8±3.7 µU/ml vs. 2.6±1.5 µU/ml, p = 0.001) and a greater proportion of patients with TSH levels above the upper limit of normal compared to Group B (38.4% vs. 7.1%, p = 0.008). Additionally, Group A exhibited a higher frequency of glutamic acid decarboxylase antibody (GADA) positivity compared to Group B (46.1% vs. 17.5%, p = 0.04). CONCLUSION: Patients positive for TPOAb exhibited significantly lower height SDS compared to TPOAb-negative patients. Additionally, T1DM patients with TPOAb positivity showed an increased frequency of GADA compared to those without TPOAb. However, no significant differences were found in HbA1c levels, C-peptide levels, or hematological parameters between TPOAb-positive and TPOAb-negative patients. These findings emphasize the impact of TPOAb on growth parameters in T1DM and advocate for routine screening of TPOAb in all T1DM patients, starting at the time of diabetes diagnosis.
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Introduction Traditionally, injuries have often been perceived as random and inevitable 'accidents'. However, in the current context, both intentional and unintentional injuries are preventable. Among these, neck injuries can be particularly complex, encompassing homicidal, suicidal, or accidental causes. Despite extensive research on the different modes and patterns of cut-throat injuries in the general population, this study aims to look deeper into this phenomenon within a unique context. Our investigation is centered in the Eastern part of India, among a tribal-dominated population who live with their traditional culture. Method In this prospective observational study, 50 cut-throat patients were included, who reported to the emergency department and then were referred to the ENT department. Parameters such as age, sex, anatomical location, mode of cut-throat injury, prior substance abuse, psychiatric issues, socioeconomic level, and length of hospital stay were considered for analysis. Results The majority (n=40, 80%) of patients belonged to tribal communities and most were young adults. Cut-throat injuries were predominantly caused by suicide (n=36, 72%) and homicide (n=12, 24%). Among tribals, 85% (n=34) of the cases were suicidal. Among suicidal cases, 86.11% (n=31) had a history of substance abuse while 22.22% (n=8) had a history of psychiatric illnesses. Conclusion In Eastern India, among the tribal-dominated population, suicide emerges as the predominant mode of cut-throat injuries, which is notably distinct from patterns observed in the general population of developing countries. These were often associated with substance abuse. Future interventions and public health efforts in these regions should consider these factors in the development of targeted strategies aimed at prevention and support for at-risk individuals.
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N95 masks filter 95% of the small particles and respiratory droplets (>0.3 µm diameter). Therefore, they are widely used both by general public and health workers during pandemic. When physical activity or exercise is performed wearing N95 mask, it induces hypercapnic environment. The heat burden is also increased leading to discomfort and reduced compliance. This study was done to compare physiological effects and subjective perceptions while wearing N95 mask and powered air-purifying respirator (PAPR) (2 fans, N95 filter) during incremental exercise. ECG, respiratory movement, SpO2, temperature inside the mask were recorded and perception of discomfort was also assessed. Heart rate variability (HRV) values during baseline were within normal limits in both the mask conditions signifying that cardiac autonomic tone is comparable. During incremental exercise, fall in SpO2 was significantly lesser in PAPR as compared to N95 mask at 60-70% and 70-80% of maximum achievable heart rate. The temperatures inside both the mask conditions were significantly higher than ambient temperature. The scores of humid, hot, breath resistance and fatigue were significantly lower in PAPR than N95 mask. In conditions where prolonged use of mask is required with strenuous physical exertion or exercise, PAPR could be preferred over N95 mask.
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Máscaras , Dispositivos de Proteção Respiratória , Humanos , Exercício Físico , Frequência Cardíaca/fisiologia , PandemiasRESUMO
INTRODUCTION: Male infertility contributes to a significant proportion of infertility cases, and advanced paternal age has been suggested to affect semen quality and fertility. However, the relationship between age and semen quality remains inconclusive, with conflicting findings reported in the literature. This study aimed to investigate the effect of age on semen quality among male partners of infertile couples in a tertiary care center in eastern India. METHODS: A cross-sectional observational study was conducted, involving 390 male participants aged 21-50 years, who were referred to the andrology laboratory for semen analysis between January 2019 and December 2022. Participants were categorized into three age groups (21-30, 31-40, and 41-50 years). Semen parameters, including sperm concentration, semen volume, motility, and morphology, were assessed according to the World Health Organization guidelines. RESULTS: Among the participants, no significant differences were observed in semen volume, motility, and morphology across different age groups. However, a statistically significant difference in sperm concentration among the three age groups was observed (p = 0.022). Spearman correlation analysis revealed a positive correlation between age and sperm concentration (r = 0.124, p = 0.013) as well as total sperm count (r = 0.10, p = 0.049). CONCLUSION: In this study, no significant decline in semen quality with age was found among male partners of infertile couples aged 21-50 years. These findings highlight the complex relationship between age and semen quality and emphasize the need for further research to better understand the underlying mechanisms and provide more conclusive evidence regarding the impact of age on male fertility.