Evaluation of neck-circumference- thyromental- distance ratio as a predictor of difficult intubation: A prospective, observational study

Background and Aims

Preoperative identification of difficult airway and subsequent planning is of utmost importance for a patient's safety. Previous studies have identified the ratio of the neck circumference (NC) to the thyromental distance (TMD); NC/TMD as a reliable predictor of difficult intubation in obese patients. But there is a lack of studies evaluating the NC/TMD in non-obese patients. Therefore, the aim of this study was to compare the NC/TMD as a predictor of difficult intubation in both obese and non-obese patients.

Methods

A prospective, observational study was conducted after obtaining institutional ethics committee clearance and written and informed consent from each patient. One hundred adult patients undergoing elective surgeries under general anaesthesia with orotracheal intubation were included in this study. Difficulty in intubation was assessed using the Intubation Difficulty Scale. The NC/TMD was calculated and the predictive accuracy of NC/TMD and other established parameters in obese and non-obese patients were compared.

Results

Univariate logistic regression analysis showed that gender, weight, body mass index, inter-incisor gap, Mallampati classification, NC, TMD, sternomental distance, and NC/TMD had a significant association with difficult intubation. NC/TMD has a higher sensitivity, specificity, and positive and negative predictive value with better predictability in comparison to other parameters.

Conclusion

The NC/TMD is a reliable and better predictor of difficult intubation in both obese and non-obese patients in comparison to NC, TMD, and sternomental distance alone.

Abstract No.: ABS2686 : Evaluation of efficacy of midazolam and propofol on postoperative nausea and Vomiting in day care surgeries - A prospective clinical study

Background & Aims:

In several studies, midazolam and propofol have been demonstrated to have some benefits with regard to postoperative nausea and vomiting(PONV). The aim of the present study was to compare the efficacy of sub-hypnotic doses of midazolam and propofol to reduce the incidence of PONV.

Methods:

Eighty patients of ASA I&II were taken up for elective ambulatory surgeries under general anaesthesia. Study patients were randomly allocated into 2 groups: Group M (n=40) received Injection Midazolam 1mg Intravenously and Group P (n=40) received Injection Propofol 20 mg intravenously 15 mins before extubation. Any additional antiemetic given to treat PONV was noted. Nausea and vomiting score was used to assess these symptoms, immediately, at 30 mins, 2hrs, 4hrs, and 6 hrs. Intraoperative and postoperative haemodynamic status and sedation were recorded and data collected was analysed statistically.

Results:

After extubation, the incidence of nausea was 5% in group P, 10% in group M, and retching was 2.5% in bothgroups(P=0.835). After 30 minutes, nausea was 15% in group P, 12.5% in group M, retching was 2.5% in both the groups(P=0.948). At 2 hours, nausea occurred in 2.5% in group P and 5% of patients in group M(P=0.556). At 4th/6th hours, no PONV occured. There was no significant difference in haemodynamic or sedation scores.

Conclusion:

From the results of the present study, it can be concluded that both that IV midazolam 1 mg and IV propofol 20 mg given 15 minutes beforeextubation are equally efficacious in preventing post-operative nausea and vomiting in patients undergoing day care surgeries.

Antimicrobial and Antioxidant Activities of Streptomyces sps Isolated from Muthupettai Mangrove Soil

Muthupet mangrove forest soil sediment was the abundant resource of the actinomycetes with distinct nature of bioactive compounds. The soil sediment was collected at 1-3meter away from bank. The present study was focused on isolation, identification and antimicrobial activity of the actinomycetes from Muthupet mangrove soil samples. Totally 32 actinomycetes strains was isolated and screened for antimicrobial activity against bacterial and fungal pathogens. Among 32 isolates 16 have antibacterial activity and 10 have antifungal activity but MG-3 and MG-4 showed maximum activity against both all the test pathogens. These two strains are gram-positive, rod-shaped, MG-3 possessing an earthy characteristic odour and MG-4 produce purple color pigment. The isolates were confirmed as Streptomyces sp. based on morphological, cultural, biochemical and physiological observations, as well as identification using the 16S rRNA gene sequence, it showed 98% similarity with Streptomyces parvus for MG-3 and Streptomyces californicus for MG-4. Bioactive compounds were extracted from Streptomyces using different solvents such as ethyl acetate, methanol, chloroform, hexane and antibacterial activities were assayed against test pathogens, ethyl acetate extract showed maximum zone of inhibition when compared with other solvents. The Minimum inhibitory concentration of ethyl acetate extract was found ranged between 1.96-3.9 μg/ml. The invitro antioxidant capacity of the crude extract was estimated by DPPH, ferric reducing power assay, H202 radical scavenging assay, phosphomolybdenum assay and total antioxidant activities. The characterization of crude extracts was analyzed by FTIR and GC-MS. From the results, it is clear that the ethyl acetate crude extract of S.parvus MG-3 and S.californicus MG-4 possesses high antimicrobial and antioxidant activity and suggested that the isolated strains could be a potential for the nature resource of pharmaceutical.