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How to cite this article: Goyal A, Pallavi K, Awasthy AK. In Response to Author: Hiccups before a Pulmonary Embolism Speak against This as a Cause. Indian J Crit Care Med 2023;27(3):229.
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How to cite this article: Goyal A, Pallavi K, Awasthy AK. Persistent Hiccups in Posterior Circulation Stroke as Rare Presentation of Pulmonary Embolism-Don't Jump the Gun. Indian J Crit Care Med 2022;26(9):1058-1059.
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Introduction: As dental implants become more widely used, there is a need to raise awareness about their potential complications. Professionals in the dental and medical fields must take responsibility for educating the public, and future professionals in these fields will play a key role in this effort. Methodology: Dental and medical students were polled through online questionnaire, with questions posed in multiple-choice format, to gauge their knowledge of dental implants. Result: When medical students were compared with dental students, it concluded that the dental students have more knowledge about implants and its complication. Conclusion: The statistical analysis revealed that the knowledge about basics of implantology and implant complications was good amongst dental students than medical students which was statistically significant.
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Neurophysiological monitoring assesses the functional integrity of the brainstem by using monitoring and mapping techniques. We report an operated case of a pontomedullary lesion in a patient who developed central hypoventilation postoperatively. The intraoperative use of neurophysiological and cardiovascular monitoring was unable to predict/prevent this hypoventilation. We describe the inherent limitations of monitoring the respiratory system, including spontaneous respiration. Moreover, we suggest the novel application of diaphragmatic motor evoked potential for real-time monitoring of respiratory pathways during brainstem surgeries.
Subject(s)
Hypoventilation , Neoplasms , Humans , Brain Stem/surgery , Decompression , Evoked Potentials, Motor/physiology , Hypoventilation/etiology , Male , Middle AgedABSTRACT
Background: Hypotension is one of the most common complications following induction of general anesthesia. Preemptive diagnosis and correcting the hypovolemic status can reduce the incidence of post-induction hypotension. However, an association between preoperative volume status and severity of post-induction hypotension has not been established in neurosurgical patients. We hypothesized that preoperative ultrasonographic assessment of intravascular volume status can be used to predict post-induction hypotension in neurosurgical patients. Our study objective was to establish the relationship between pre-induction maximum inferior vena cava (IVC) diameter, collapsibility index (CI), and post-induction reduction in mean arterial blood pressure in neurosurgical patients. Materials and Methods: A prospective observational study was conducted including 100 patients undergoing elective intracranial surgeries. IVC assessment was done before induction of general anesthesia. Receiver operating characteristic (ROC) curve analysis was used to determine the cutoff values of maximum and minimum IVC diameter (IVCDmax and IVCDmin, respectively) and CI for prediction of hypotension. Results: Post-induction hypotension was observed in 41% patients. Patients with small IVCDmax and higher CI% developed hypotension. The areas under the ROC curve (AUCs) were 0.64 (0.53-0.75) for IVCDmax and 0.69 (0.59-0.80) for IVCDmin. The optimal cutoff values were1.38 cm for IVCDmax and 0.94 cm for IVCDmin. The AUC for CI was 0.65 (0.54-0.77) and the optimal cutoff value was 37.5%. Conclusion: Pre-induction IVC assessment with ultrasound is a reliable method to predict post-induction hypotension resulting from hypovolemia in neurosurgical patients.