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Liu X, Cheng Z, Chen X, Rao Z, Wang A. A Neural Integrity Monitor Electromyography Endotracheal Tube Causes More Severe Postoperative Sore Throat Than a Standard Endotracheal Tube in Adults: A Prospective Cohort Study. World J Surg 2023; 47:2409-2415. [PMID: 37555971 DOI: 10.1007/s00268-023-07092-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND This study aimed at figuring out the different effects of a neural integrity monitor electromyography endotracheal tube (NIM-EMG-ETT) and a standard endotracheal tube (ETT) on postoperative sore throat (POST). METHODS This prospective cohort study enrolled 143 patients scheduled to undergo general anesthesia with endotracheal intubation. Patients were allocated into three groups: Group A, non-thyroid surgery with a standard ETT; Group B, thyroid surgery with a standard ETT; Group C, thyroid surgery with a NIM-EMG-ETT. The incidence, the severity and visual analog scale (VAS) of POST were recorded. The incidence and the severity of POST were tested by χ2 test or Fisher's exact test. And VAS of POST was tested by Kruskal-Wallis test. RESULTS The incidences of POST in Group B and Group C were significantly higher than that of Group A at all the time points after extubation (P < 0.001). The incidences of POST in Group C was significantly higher than that in Group B at 8 h, 24 h and 48 h after extubation (89.4% vs. 68.8%, P = 0.014, relative risk (RR) 1.30, 95% confidence interval (CI) 1.05-1.61; 89.4% vs. 58.3%, P = 0.001, RR 1.53, 95% CI 1.18-1.98; 76.6% vs. 45.8%, P = 0.002, RR 1.67, 95% CI 1.18-2.36). Moreover, there was a significant higher VAS of POST and more serious POST with Group C than with Group B. CONCLUSIONS A NIM-EMG-ETT may induce higher incidence of POST and more serious POST than a standard ETT. TRAIL REGISTRATION Chinese Clinical Trail Registry ( http://www.chictr.org.cn/index.aspx , ChiCTR2200058896, 2022-4-18).
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Affiliation(s)
- Xi Liu
- Department of Anesthesiology, Shanghai 6th Peoples Hospital Affiliated to Shanghai Jiao Tong University, NO.600, Yishan Road, Xuhui District, Shanghai, China
| | - Zhongliang Cheng
- Department of Anesthesiology, Shanghai Ocean University, No.999, Huchenghuan Road, Nanhui New City, Shanghai, China
| | - Xiaoxiao Chen
- Department of Anesthesiology, Shanghai 6th Peoples Hospital Affiliated to Shanghai Jiao Tong University, NO.600, Yishan Road, Xuhui District, Shanghai, China
| | - Zhenghuan Rao
- Department of Anesthesiology, Shanghai 6th Peoples Hospital Affiliated to Shanghai Jiao Tong University, NO.600, Yishan Road, Xuhui District, Shanghai, China
| | - Aizhong Wang
- Department of Anesthesiology, Shanghai 6th Peoples Hospital Affiliated to Shanghai Jiao Tong University, NO.600, Yishan Road, Xuhui District, Shanghai, China.
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Okello M, Bakeera-Kitaka S, Ocama P, Nabwire EP, Darshit D, Namata C, Tinka AA. Endoscopic esophageal foreign body removal among children at Lubaga Hospital, Kampala, Uganda. Afr Health Sci 2023; 23:223-227. [PMID: 38357102 PMCID: PMC10862611 DOI: 10.4314/ahs.v23i3.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Background Diagnostic upper gastrointestinal endoscopy involves examination of the lining of the esophagus, stomach and part of the duodenum. Interventional endoscopy in addition to evaluating the upper gastrointestinal tract to make a diagnosis, also offers a treatment benefit. Traditionally, esophageal foreign bodies (FBs) in Uganda were removed using rigid endoscopy. We therefore report an emerging trend of using flexible endoscopy to remove these FBs. Objective To describe participant characteristics and endoscopic findings among children who underwent esophageal FB removal in Lubaga Hospital in Kampala. Methods This was a retrospective review of endoscopy reports for children who underwent endoscopic esophageal FB removal at Lubaga Hospital from December 2014 to March 2022. Results Overall, 61 symptomatic children underwent this procedure. The majority of the FBs were removed by flexible endoscopy (n=55, 90.16%). The mean age of the participants was 7.88 (SD=2.12) years old. The majority of the children were females (72.13%) and coins were the most ingested FBs (84%), others included steel crucifix, nails etc. The upper esophageal sphincter was the commonest site for FB impaction (74%). Conclusion We report high success rates of 90.16% for endoscopic removal of impacted esophageal foreign bodies among Ugandan children using the now widely available flexible endoscopy.
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Affiliation(s)
- Michael Okello
- Department of Anatomy, Makerere University College of Health Sciences
- Lubaga Hospital, Kampala, Uganda
| | | | - Ponsiano Ocama
- Department of Medicine, Makerere University College of Health Sciences
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Khorasani Esmaili P, Dabiri S, Reza Mirshekari T, Nabi Pour F, Shamsadini A, Eslami H, Damghani MA, Arabi AA, Aamizadeh M, Fani Maleki F, Gharaie N, Pouradeli S. Rhinocerebral Mucormycosis Following COVID-19 Infection in Iran. IRANIAN JOURNAL OF PATHOLOGY 2023; 18:116-124. [PMID: 37600568 PMCID: PMC10439752 DOI: 10.30699/ijp.2023.545953.2845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 11/30/2023] [Indexed: 08/22/2023]
Abstract
Background & Objective Mucormycosis (also called black fungus) is an opportunistic serious fungal infection caused by mucormycetes. It can occur in diabetes mellitus patients and other immunosuppressive conditions with recent predisposing factors such as maxillofacial surgery and corticosteroid usage. Methods In this study, 14 patients were referred to the otorhinolaryngology or ophthalmology ward of Shafa Hospital (Kerman, Iran) with primary symptoms of nasal fullness and facial nerve dysfunction; they were admitted to the hospital to rule out the fungal infection. An endoscopic biopsy was taken from facial sinuses or orbit, and a microscopic evaluation was performed using hematoxylin and eosin (H&E) and periodic acid-Schiff (PAS) staining methods to rule out mucormycosis. Results In the histopathological examination, broad-based nonseptate branching fungal hyphae were found in nasal sinuses through the endoscopic biopsy. Most of the patients had diabetes mellitus with a primary symptom of facial nerve palsy; also, most of them received corticosteroids (intravenous [IV] or intramuscular [IM] injection). All patients have recently been infected with COVID-19 (less than 1 month ago). Conclusion COVID-19 infection might be a predisposing factor for many opportunistic infections, such as fungal elements); thus, the physician should be aware of the dosage and duration of corticosteroid therapy to prevent the development of these infections.
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Affiliation(s)
- Parisa Khorasani Esmaili
- Department of Pathology, Pathology and Stem Cell Research, Afzali Pour Medical Faculty, Kerman University of Medical Science, Kerman, Iran
| | - Shahriar Dabiri
- Department of Pathology, Pathology and Stem Cell Research, Afzali Pour Medical Faculty, Kerman University of Medical Science, Kerman, Iran
| | - Touraj Reza Mirshekari
- Department of Pathology, Shafa Hospital, Kerman University of Medical Science, Kerman, Iran
| | - Fatemmeh Nabi Pour
- Department of Pathology, Shafa Hospital, Kerman University of Medical Science, Kerman, Iran
| | - Ayeh Shamsadini
- Department of Otorhinolaryngology and Head & Neck Surgery, Shafa Hospital, Kerman University of Medical Science, Kerman, Iran
| | - Hadi Eslami
- Department of Otorhinolaryngology and Head & Neck Surgery, Shafa Hospital, Kerman University of Medical Science, Kerman, Iran
| | - Mohammadad Ali Damghani
- Department of Otorhinolaryngology and Head & Neck Surgery, Shafa Hospital, Kerman University of Medical Science, Kerman, Iran
| | - Ali Asghar Arabi
- Department of Otorhinolaryngology and Head & Neck Surgery, Shafa Hospital, Kerman University of Medical Science, Kerman, Iran
| | - Maryam Aamizadeh
- Department of Otorhinolaryngology and Head & Neck Surgery, Shafa Hospital, Kerman University of Medical Science, Kerman, Iran
| | - Fatemeh Fani Maleki
- Department of Otorhinolaryngology and Head & Neck Surgery, Shafa Hospital, Kerman University of Medical Science, Kerman, Iran
| | - Navid Gharaie
- Department of Otorhinolaryngology and Head & Neck Surgery, Shafa Hospital, Kerman University of Medical Science, Kerman, Iran
| | - Shiva Pouradeli
- Clinical Research Development Unit, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
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Anish Poorna T, Jayalakshmi PS, Alagarsamy R, Joshna EK, Sathikala L. Frequency and Difficulty in the Usage of Face Shields Among Oral and Maxillofacial Surgeons During the COVID-19 Era: An Online Survey. J Maxillofac Oral Surg 2023:1-6. [PMID: 37362878 PMCID: PMC10169170 DOI: 10.1007/s12663-023-01928-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 04/26/2023] [Indexed: 06/28/2023] Open
Abstract
Aim During the COVID-19 era, personal protective equipment (PPE) has become a necessary part of surgeons' routines, and face shields are considered an additional barrier to prevent disease transmission via aerosols. This study aimed to evaluate how often oral and maxillofacial surgeons (OMFS) use face shields and the challenges they face while using them. Methods An online survey consisting of fourteen questions was distributed to OMFS, and the responses were collected and analyzed using the chi-square test to determine any associations between categorical variables. A P-value of ≤ 0.05 was considered statistically significant. Results Out of the 310 OMFS who responded to the survey (181 males, 129 females, 235 residents, 10 fellows, and 65 practitioners), 42.9% (133/310) and 39.4% (122/310) reported using face shields for minor and major surgical procedures, respectively. The majority of the respondents (74.1%, 230/310) reported decreased efficiency while using a face shield. Reasons for non-compliance included vision-related issues, headache, difficulties with disinfection, and ergonomic factors. Conclusion Based on the survey results, the regular use of face shields by OMFS was less frequent, and almost three-fourths of the surgeons found it challenging to use due to various reasons. The reduced compliance with face shield usage highlights the need for more ergonomic face shields to improve compliance.
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Affiliation(s)
- T. Anish Poorna
- Department of Oral & Maxillofacial Surgery, Government Dental College, Kottayam, Kerala India
| | - P. S. Jayalakshmi
- Department of Oral & Maxillofacial Surgery, Government Dental College, Kottayam, Kerala India
| | - Ragavi Alagarsamy
- Department of Burns, Plastic and Maxillofacial Surgery, VMMC and Safdarjung Hospital, New Delhi, India
| | - E. K. Joshna
- Department of Oral & Maxillofacial Surgery, Government Dental College, Kottayam, Kerala India
| | - L. Sathikala
- Department of Maths and Statistics, RAMCO Institute of Technology, Rajapalayam, India
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Alhussien A, Alghulikah A, Albaharna H, Alserhani A. Loss of Vision Outcome for Allergic Fungal Sinusitis: Case Report and Literature Review. THERAPEUTIC ADVANCES IN ALLERGY AND RHINOLOGY 2023; 14:27534030231176774. [PMID: 37313392 PMCID: PMC10259143 DOI: 10.1177/27534030231176774] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 05/03/2023] [Indexed: 06/15/2023]
Abstract
Visual loss is a rare manifestation of allergic fungal rhinosinusitis (AFRS). We report a case of an adult male who was diagnosed with AFRS and who presented during the COVID-19 pandemic lockdown with sudden-onset complete vision loss and a lack of recovery after surgical and medical management. We reviewed the literature on reported cases of AFRS complicated by visual loss to identify factors associated with visual outcomes. We found 50 patients who were diagnosed with acute visual loss due to AFRS, with an average age of 28 ± 14 years. Complete and partial recovery after surgical intervention were reported in 17 and 10 cases, respectively. However, the absence of vision improvement was reported in 14 of the cases. Early diagnosis and prompt intervention can return vision back to normal. However, delayed presentation, complete loss of vision, and acute onset of visual loss are associated with worse outcomes.
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Affiliation(s)
- Ahmed Alhussien
- Otolaryngology - Head & Neck Surgery Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulrahman Alghulikah
- Otolaryngology - Head & Neck Surgery Unit, Surgery Department, Security Forces Hospital Program, Riyadh, Saudi Arabia
| | - Hussain Albaharna
- Otolaryngology ‐ Head and Neck Surgery Department, Qatif Central Hospital, Qatif City, Saudi Arabia
| | - Abdulrahman Alserhani
- Otolaryngology ‐ Head and Neck Surgery Department, Ad Diriyah Hospital, Riyadh, Saudi Arabia
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Puri A, Ghosh SK, Singh G, Madan A. Gargling with ketamine preoperatively decreases postoperative sore throat after endotracheal intubation in middle ear surgeries: A prospective randomized control study. Indian J Otolaryngol Head Neck Surg 2022; 74:5739-5743. [PMID: 36742572 PMCID: PMC9895345 DOI: 10.1007/s12070-021-03062-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 12/27/2021] [Indexed: 02/07/2023] Open
Abstract
Postoperative sore throat (POST) is the eighth most common side effect in the postoperative period. Though it is considered as a minor side effect, it can lead to significant discomfort for the patient. Increased morbidity due to postoperative sore throat could have a big impact on outcomes with an increased economic burden to the nation. To determine the efficacy of ketamine gargle on a postoperative sore throat, we compared ketamine gargle with a normal saline gargle. Furthermore, we studied their efficacy on postoperative cough and hoarseness of voice. We randomly allocated 60 patients of ASA-I and II into two groups equally in patients posted for middle ear surgeries under general anaesthesia. Patients of the group- K were asked to gargle with 40 mg ketamine mixed with 29 ml normal saline preoperatively. Group- C patients were given 30 ml normal saline to gargle. Airway manipulation in all patients was done by senior anesthesiologists in the operating room. Patients were observed and interviewed at 1 h, 6 h, and 24 h after extubation for postoperative sore throat, cough, and hoarseness of voice. In the control group, the incidence of postoperative sore throat at 1 h, 6 h, and 24 h was 50%, 43.3%, and 36.7% respectively. When we compared the incidence in the ketaminegroup (Group-K) with the control group it showed that they were significantly lower (p-value ≤ 0.05) at all three observation points. On the other hand, ketamine gargle has no significant protective effect on the severity of postoperative sore throat, cough, and hoarseness of voice. Ketamine gargle in this study, showed significantly effective in attenuating postoperative sore throat in patients undergoing tracheal intubation for elective surgeries.
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Affiliation(s)
- Anisha Puri
- Department of Anaesthesiology, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala, India
| | - Subir Kumar Ghosh
- Department of Anaesthesiology, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala, India
| | - Gurchand Singh
- Department of Otolaryngology and Head & Neck Surgery, Maharishi Markandeshwar (Deemed to be) University, Mullana, Ambala, India
| | - Anita Madan
- Department of Obstetrics and Gynaecology, Government Medical College, Amritsar, India
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Ganesapillai M, Mondal B, Sarkar I, Sinha A, Ray SS, Kwon YN, Nakamura K, Govardhan K. The face behind the Covid-19 mask - A comprehensive review. ENVIRONMENTAL TECHNOLOGY & INNOVATION 2022; 28:102837. [PMID: 35879973 PMCID: PMC9299984 DOI: 10.1016/j.eti.2022.102837] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/16/2022] [Accepted: 07/16/2022] [Indexed: 05/07/2023]
Abstract
The threat of epidemic outbreaks like SARS-CoV-2 is growing owing to the exponential growth of the global population and the continual increase in human mobility. Personal protection against viral infections was enforced using ambient air filters, face masks, and other respiratory protective equipment. Available facemasks feature considerable variation in efficacy, materials usage and characteristic properties. Despite their widespread use and importance, face masks pose major potential threats due to the uncontrolled manufacture and disposal techniques. Improper solid waste management enables viral propagation and increases the volume of associated biomedical waste at an alarming rate. Polymers used in single-use face masks include a spectrum of chemical constituents: plasticisers and flame retardants leading to health-related issues over time. Despite ample research in this field, the efficacy of personal protective equipment and its impact post-disposal is yet to be explored satisfactorily. The following review assimilates information on the different forms of personal protective equipment currently in use. Proper waste management techniques pertaining to such special wastes have also been discussed. The study features a holistic overview of innovations made in face masks and their corresponding impact on human health and environment. Strategies with SDG3 and SDG12, outlining safe and proper disposal of solid waste, have also been discussed. Furthermore, employing the CFD paradigm, a 3D model of a face mask was created based on fluid flow during breathing techniques. Lastly, the review concludes with possible future advancements and promising research avenues in personal protective equipment.
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Affiliation(s)
- Mahesh Ganesapillai
- Mass Transfer Group, School of Chemical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Bidisha Mondal
- Mass Transfer Group, School of Chemical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Ishita Sarkar
- Mass Transfer Group, School of Chemical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Aritro Sinha
- Mass Transfer Group, School of Chemical Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Saikat Sinha Ray
- Department of Urban and Environmental Engineering, Ulsan National Institute of Science and Technology, Republic of Korea
| | - Young-Nam Kwon
- Department of Urban and Environmental Engineering, Ulsan National Institute of Science and Technology, Republic of Korea
| | - Kazuho Nakamura
- Faculty of Engineering, Division of Material Science and Chemical Engineering, Yokohama National University, Tokiwadai, Yokohama, Kanagawa 240-8501, Japan
| | - K Govardhan
- Department of Micro and Nano-Electronics, School of Electronics Engineering, Vellore Institute of Technology, Vellore, Tamil Nadu, India
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Kore SS, Ubhe SB, Fasil F. Comparison Between Dexamethasone and Fentanyl as an Adjuvant to Bupivacaine and Lignocaine in Supraclavicular Brachial Plexus Block for Upper Limb Surgery. J Pharmacol Pharmacother 2022. [DOI: 10.1177/0976500x221085803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Interest in supraclavicular brachial plexus blocks has been rekindled using sonographic guidance to locate the brachial plexus. Various adjuncts have been suggested to potentiate the anesthetic and analgesic effects of local anesthetic agents. We designed this randomized double-blind controlled study to compare the effects of dexamethasone and fentanyl when added to a mixture of bupivacaine and lignocaine in supraclavicular blocks in patients undergoing forearm surgeries. Methods: Sixty-six patients aged between 20 to 60 years old belonging to ASA one or two were recruited prospectively, double-blinded, and randomized way. Supraclavicular block under sonographic guidance was performed in the three groups by using injection bupivacaine (0.5%) 20 cc + injection lignocaine (2%) 10 cc + injection 0.9% normal saline; 2ml (Group S), injection bupivacaine (0.5%) 20 cc + injection lignocaine (2%) 10 cc + injection dexamethasone 8 mg (Group D), and injection bupivacaine (0.5%) 20 cc + injection lignocaine (2%) 10 cc + injection fentanyl 50 µgm (Group F). The onset time of sensory and motor block, duration of sensory and motor block, and hemodynamic variables were recorded. Results: Group D showed a significantly greater sensory and motor block duration than other groups ( P = .001). Comparison of hemodynamic variables failed to reveal any statistically significant differences between all groups. Conclusion: Both dexamethasone and fentanyl are good adjuvants in the supraclavicular block, but dexamethasone is better, given faster onset and duration of analgesia.
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Affiliation(s)
- Shilpa Sarang Kore
- Department of Anaesthesia, Dr D.Y. Patil Medical College, Dr D.Y Patil Vidyapeeth, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India
| | - Smita Bhau Ubhe
- Department of Anaesthesia, Dr D.Y. Patil Medical College, Dr D.Y Patil Vidyapeeth, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India
| | - Fathima Fasil
- Department of Anaesthesia, Dr D.Y. Patil Medical College, Dr D.Y Patil Vidyapeeth, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India
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Ning Q, Wu D, Wang X, Xi D, Chen T, Chen G, Wang H, Lu H, Wang M, Zhu L, Hu J, Liu T, Ma K, Han M, Luo X. The mechanism underlying extrapulmonary complications of the coronavirus disease 2019 and its therapeutic implication. Signal Transduct Target Ther 2022; 7:57. [PMID: 35197452 PMCID: PMC8863906 DOI: 10.1038/s41392-022-00907-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/10/2022] [Accepted: 01/17/2022] [Indexed: 02/06/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) is a highly transmissible disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that poses a major threat to global public health. Although COVID-19 primarily affects the respiratory system, causing severe pneumonia and acute respiratory distress syndrome in severe cases, it can also result in multiple extrapulmonary complications. The pathogenesis of extrapulmonary damage in patients with COVID-19 is probably multifactorial, involving both the direct effects of SARS-CoV-2 and the indirect mechanisms associated with the host inflammatory response. Recognition of features and pathogenesis of extrapulmonary complications has clinical implications for identifying disease progression and designing therapeutic strategies. This review provides an overview of the extrapulmonary complications of COVID-19 from immunological and pathophysiologic perspectives and focuses on the pathogenesis and potential therapeutic targets for the management of COVID-19.
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Affiliation(s)
- Qin Ning
- National Medical Center for Major Public Health Events, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Di Wu
- National Medical Center for Major Public Health Events, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaojing Wang
- National Medical Center for Major Public Health Events, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dong Xi
- National Medical Center for Major Public Health Events, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Chen
- National Medical Center for Major Public Health Events, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guang Chen
- National Medical Center for Major Public Health Events, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongwu Wang
- National Medical Center for Major Public Health Events, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiling Lu
- National Medical Center for Major Public Health Events, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ming Wang
- National Medical Center for Major Public Health Events, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lin Zhu
- National Medical Center for Major Public Health Events, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junjian Hu
- National Medical Center for Major Public Health Events, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tingting Liu
- National Medical Center for Major Public Health Events, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ke Ma
- National Medical Center for Major Public Health Events, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meifang Han
- National Medical Center for Major Public Health Events, Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Xiaoping Luo
- National Medical Center for Major Public Health Events, Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Puri A, Singh G, Madan A. Fentanyl and clonidine as adjuncts to a mixture of local anesthetics in potentiating postoperative analgesia in supraclavicular block: A randomized controlled study. Int J Crit Illn Inj Sci 2020; 10:163-169. [PMID: 33850823 PMCID: PMC8033203 DOI: 10.4103/ijciis.ijciis_68_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/23/2019] [Accepted: 02/24/2020] [Indexed: 11/10/2022] Open
Abstract
Background: Brachial plexus block is popular for upper limb surgeries as it is effective for postoperative analgesia. Aims: The aim of the study was to compare fentanyl and clonidine as adjuncts to a mixture of local anesthetics in potentiating postoperative analgesia in the supraclavicular block. Materials and Methods: Sixty patients of the American Society of Anesthesiologist I and II undergoing upper limb surgeries lasting more than 30 min were included and randomly divided into two groups of 30 each. In clonidine (C) group, patients received 10 ml of 0.5% bupivacaine + 20 ml of 2% lignocaine with adrenaline (1:200,000) and 1 μg/kg clonidine diluted till 35 cc with normal saline. In fentanyl (F) group, patients received 10 ml of 0.5% bupivacaine + 20 ml of 2% lignocaine with adrenaline (1:200,000) and 1 μg/kg fentanyl diluted till 35 cc with normal saline. Patients were observed for onset and duration of sensory and motor blockade, duration of analgesia, postoperative pain, and adverse effects. Results: The mean onset of sensory block was faster in Group F (8.43 ± 2.897 min) as compared to 13.17 ± 2.451 min in Group C. The difference between the two groups was statistically strongly significant (P < 0.0001). There was a significant reduction in the onset of motor block in Group F (14.67 ± 1.84 min) compared to (18.17 ± 2.45 min) Group C with P < 0.0001 (statistically strongly significant). There was a significant increase in the duration of analgesia in Group C (16.63 ± 2.04 h) compared to Group F (8.79 ± 1.50 h) with P < 0.0001. There was bradycardia (pulse did not fall below 60) in two patients of Group C (treated with atropine intravenous [i.v.]). Two patients of Group F complained of nausea and vomiting once in the early hours of surgery for which ondansetron i.v. was given. There were no significant side effects in either of the groups. Conclusion: Both clonidine and fentanyl establish a good safety profile. Fentanyl ensures a faster onset of sensory and motor blockade, while clonidine ensures a longer duration of sensory and motor blockade as well as prolonged analgesia.
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Affiliation(s)
- Anisha Puri
- Department of Anesthesiology, Maharishi Markandeshwar, Ambala, Haryana, India
| | - Gurchand Singh
- Department of ENT, Maharishi Markandeshwar, Ambala, Haryana, India
| | - Anita Madan
- Deparment of Obstetrics and Gynaecology, Government Medical College, Amritsar, Punjab, India
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