Ideal Length of Oral Endotracheal Tube for Critically Ill Intubated Patients in an Asian Population: Comparison to Current Western Standards.

Background Endotracheal (ET) intubation is used to maintain the airway patency of patients during mechanical ventilation and is inserted at a particular depth into the trachea through the nose, mouth, or through an incision in the neck. The aim of our study was to validate the ideal length of an oral endotracheal tube (ETT) in the Asian population compared to Western standards. Methods Patient records with an oral ETT inserted between April 2011 and June 2015 in the Intensive Care Unit (ICU) of a hospital were retrospectively analyzed. The key variables included demographics, height, and ideal body weight of the patient, length of the oral ETT, and chest X-rays. Statistical analyses were performed using R software (https://cran.r-project.org/). Results There were 876 incidences of oral cuffed ETT insertions in 708 adult patients ≥ 18 years of age. The median ETT depth in all the ethnic groups (Chinese, Malay, Indians, and others) was 22 cm. The median depth of oral ETTs was 22 cm in males and 21 cm in females as compared to Western standards (males: P < 0.0001; females: P = 0.93). In ICU patients intubated with an ETT at an acceptable distance from the carina (2 - 5 cm), the median ETT depth was different in males (P < 0.0001) but was similar in females (P = 0.87). Conclusion We suggest that males and females in the Asian population, especially in South East Asia, should have their ETTs secured at the corner of mouth by at least 1 cm less in comparison to the Western population (22 cm in males and 20 cm in females).

Comparative Transcriptional Profiling of Primed and Non-primed Rice Seedlings under Submergence Stress.

Submergence stress is a limiting factor for direct-seeded rice systems in rainfed lowlands and flood-prone areas of South and Southeast Asia. The present study demonstrated that submergence stress severely hampered the germination and seedling growth of rice, however, seed priming alleviated the detrimental effects of submergence stress. To elucidate the molecular basis of seed priming-induced submergence tolerance, transcriptome analyses were performed using 4-day-old primed (selenium-Se and salicylic acid-SA priming) and non-primed rice seedlings under submergence stress. Genomewide transcriptomic profiling identified 2371 and 2405 transcripts with Se- and SA-priming, respectively, that were differentially expressed in rice compared with non-priming treatment under submergence. Pathway and gene ontology term enrichment analyses revealed that genes involved in regulation of secondary metabolism, development, cell, transport, protein, and metal handling were over-represented after Se- or SA-priming. These coordinated factors might have enhanced the submergence tolerance and maintained the better germination and vigorous seedling growth of primed rice seedlings. It was also found that many genes involved in cellular and metabolic processes such as carbohydrate metabolism, cellular, and metabolic biosynthesis, nitrogen compound metabolic process, transcription, and response to oxidative stress were induced and overlapped in seed priming treatments, a finding which reveals the common mechanism of seed priming-induced submergence tolerance. Taken together, these results may provide new avenues for understanding and advancing priming-induced responses to submergence tolerance in crop plants.

What factors influence emergency department staff attitudes towards using information technology?

OBJECTIVES: Information technology (IT) has an important role in the emergency department (ED) functioning, but staff attitudes can influence the way IT is used. Qualitative research into the perceptions of the ED staff has identified a variety of individual, environmental and system factors that may influence attitudes towards using IT. The authors aimed to determine which factors predict attitudes towards using IT and which factors are the most influential. METHODS: Findings from a previous qualitative study were used to develop a self-administered questionnaire measuring individual, environmental and system factors, along with staff attitudes towards using IT. The questionnaire was sent to 535 staff working in three English EDs. Simple linear regression was used to examine the relationship between each potential predictor and user attitude, and multiple regression was used to identify the most important predictors. RESULTS: Completed questionnaires were returned by 362/535 participants (68%). The factors with the strongest positive association with staff attitudes towards using IT were the perceived individual impact of technology (r(2)=39%, p<0.001), perceived usefulness (r(2)=7%, p<0.001), perceived ease of use (r(2)=2%, p=0.006), perceived subjective norms (r(2)=1%, p=0.013) and computer experience (r(2)=1%, p=0.034). CONCLUSION: The perceived individual impact of technology is the most important factor in determining ED staff attitude towards using IT. The ED staff are more likely to view using IT systems positively if they can see direct individual benefits arising from their use.

Fine needle aspiration cytology: sensitivity and specificity in thyroid lesions.

BACKGROUND: Thyroid enlargement is one of the common problems in patients presenting at outpatients department of ENT particularly in females. Thyroid nodules are common, thyroid cancer is uncommon and the most common way for it to present is as a solitary thyroid nodule. This study was conducted to evaluate the sensitivity and specificity of Fine Needle Aspiration Cytology (FNAC) in thyroid diseases. METHOD: This prospective analytic study was conducted at ENT Department of Karachi Medical and Dental College/Abbasi Shaheed Hospital during year 2004-8. One hundred and five cases were enrolled who underwent thyroid surgery after complete evaluation by history, clinical examination, Thyroid profile, Thyroid Scintigraphy, Ultrasound neck and FNAC. In cases which were revealed malignant by FNAC, CT scan were done to see the extent of disease and neck node status. Surgery was done in all cases and specimens sent for histopathology. RESULTS: Male to female ratio of the patients was 1:8.5. Most common lesion was benign nodule (96). Malignant lesions were 9 in FNAC. In histopathology, the benign nodules were 92, and malignant cases were 13. Sensitivity of FNAC was 61.53% and specificity was 98.9%. CONCLUSION: FNAC in Thyroid has high sensitivity and specificity.