Browsing by Author "Dinesh Kumar Singh"

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A comparative study of two methods of nasal tracheal fiberoptic intubation
(Faculty of Anaesthesia, Pain and Intensive Care, AFMS, 2018) Rajesh Kumar Meena; Ronak Rajen Mankodi; Kavita Meena; Dinesh Kumar Singh; Shashi Prakash
Introduction: Conventional fiberoptic intubation in a well anesthetized and prepared airway is found difficult with success rates of around 68%. The difficulty presents in the form of longer duration taken for intubation, coughing and bleeding. This study aimed to compare two facilitated methods designed to reduce time taken, complication rate, ease of insertion and hemodynamic stability. Methodology: After institute ethical committee clearance and a written informed consent, patients were randomly divided into two groups. Both groups were prepared, as per current standards. In Group-A (endotracheal tube group), the endotracheal tube was first inserted till 18 cm mark at the alae of nose. Fiberscope was passed through the tube, and navigated to pass through the true vocal cords and its adequate placement was confirmed. In the other group - Group-B (nasopharyngeal airway group), a spirally split Rusch nasopharyngeal airway of adequate size was warmed, lubricated and inserted in the nasal cavity. Fiberscope was passed through the airway, vocal cords were visualized, and the nasopharyngeal airway was removed before railroading the preloaded tube through the vocal cords and correct placement was confirmed. Time taken to intubate, cough episodes, bleeding and hemodynamic parameters were recorded. Results: The time taken for intubation in Group-A was 79.76 sec as compared to 44.15 sec in Group-B (p < 0.001). The increase in heart rate and mean arterial blood pressure were found to be significantly higher Group-A than those in Group-B. Conclusion: We conclude that split nasopharyngeal airway is better in assisting awake fiberoptic nasal intubation than through the endotracheal tube in terms of less time taken and better hemodynamic parameters. © Anaesthesia, Pain & Intensive Care, 2010-2013.
A Multiple Millimeter-Wave 5G MIMO Antenna Including n257/n258/n259/n260/n261 FR2-Bands with High Diversity Performance
(Institute of Electrical and Electronics Engineers Inc., 2023) Manish Sharma; Kanhaiya Sharma; Smrity Dwivedi; Dinesh Kumar Singh; Rana Gill; Naresh Kumar
This communication focuses on a two-port MIMOWB configuration wide-bandwidth antenna for future 5G high-speed wireless applications radiating electromagnetic energy. The single-port antenna offers impedance bandwidth of 24.50GHz-41.675GHz for HFSS EM-simulator and 23.63GHz-43.13GHz for CST-Microwave Studio EM-simulator. The square-radiating patch radiating EM-wave with the rectangular slot on top-surface & beveled-ground on the bottom surface of dielectric with permittivity 2.20 and thickness 0.787. Also, the compact dimension of the antenna is 12.0 × 15.0 mm2 and the two-port transformed dimensions are 24.0 × 15.0 mm2. The SFD studying surface-current-distribution (SCD) with directional 2-D radiation patterns in n257, n258, n259, n260, and n261 5G-millimeter wave bands infrastructure. The MIMO antenna also offers averaged peak gain of 4.50dBi with high diversity ECC and DG parameters. © 2023 IEEE.
Antitubercular drug poisoning in a pregnant woman
(2010) Rahul Dutta; Surya Kumar Dube; Dinesh Kumar Singh
A 20-year-old female in her third month of pregnancy, presented with generalised tonic clonic seizures, metabolic acidosis and coma following suicidal ingestion of antitubercular medication. We successfully managed the case with pyridoxine, sodium bicarbonate and mechanical ventilation.
Comparative study of two ionotropes levosimendan and dobutamine in critically ill patients suffering from heart failure
(Faculty of Anaesthesia, Pain and Intensive Care, AFMS, 2018) Dharmendra Jain; Sandeep Loha; Dhirendra Chandrakar; Manimoy Debburma; Dinesh Kumar Singh
Objective: Acute heart failure frequently happens in critically ill patients due to myocardial injury, cardiac dysfunction, arrhythmias, and inflammatory mediators. Till now, the outcomes of studies comparing levosimendan with dobutamine for patients requiring inotropic support remain controversial and ambiguous. The present study was aimed to compare the effects of levosimendan and dobutamine in the management of critically ill patients in ICU and establish preference of one over the other drug. Methodology: In this study 100 critically ill patients with clinical diagnosis of heart failure or impending heart failure due to any cause of age between 21 years to 80 years (left ventricular ejection fraction < 35%) in ICU were included and randomly divided into 2 groups; Group-1 (n=50) received inj levosimendan and Group-2 (n=50) which received inj dobutamine. The parameters recorded during study were: heart rate (beats/min), systolic blood pressure (mmHg), stroke volume (ml), cardiac output (l/min), cardiac index (l/min/m2), brain natriuretic peptide (pg/ml), requirement of ionotropic agent and 7 day survival. Baseline parameters of the patient at “0” h was recorded, then the ionotrope (levosimendan or dobutamine) was started. After this the parameters were recorded at 24 h, 48 h and 5th day of study and follow-up of patient was done upto 7 days. SPSS for Windows version 16.0 software was used for statistical analysis. For non-continuous data Chi-square test was used. The mean and standard deviation of the parameters compared using student “t” test. The p < 0.05 was considered as significant. Results: The distribution of patients according to age, sex and body surface area was comparable (p > 0.05) in both the groups. Heart rate decreased significantly in both the groups at 24 h and 5th day, although it remained higher in Group-1 patients receiving levosimendan. Systolic blood pressure and Cardiac Index (CI) increased significantly in both the groups but was more in Group-1 patients receiving levosimendan at all times. Cardiac output increased significantly in Group-1 pts whereas in Group-2, after an initial increase for first 48 hrs ultimately decrease in cardiac output was observed on 5th day. 7 Day survival was more (56%) in Group-1 patients as compared to 52% in Group-2 patients. Conclusion: Based upon the results of our study, we conclude that levosimendan shows better results than dobutamine in maintaining hemodynamic stability in critically ill patients. Larger, multi-center studies may have to be done for confirming or discrediting our results. © 2018 Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved.
Comparison of sedative efficacy of epidural bupivacaine 0.5% with lignocaine 2% plus adrenaline by measuring BIS guided propofol requirement in gynaecological surgery
(2012) Ghanshyam Yadav; Chandra Sekhar Pradhan; Surendra Kumar Gupta; Gaurav Jain; Sandeep Khuba; Dinesh Kumar Singh
Objectives: This study was conducted to compare the sedative efficacy of bupivacaine 0.5% with lignocaine 2% plus adrenaline in epidural anaesthesia by using BIS monitor. Study design: A randomized, double blind study. Methodology: Sixty patients, ASA physical status I or II, of age group 20-65 yrs, undergoing elective gynaecological surgery under epidural anaesthesia, were randomly but equally placed into two groups (group-B and group-L). Patients received (2ml/segment) bupivacaine 0.5% or lignocaine 2% with adrenaline in group-B and group-L respectively, to achieve a sensory block up to T8 level. After confirmation of sensory blockade, propofol infusion was started at a rate of 100 μg/kg/min to get a BIS value of ≤ 80 and the time was measured (onset time). Surgery was allowed to start immediately after the onset time. Propofol infusion was titrated to maintain the BIS value at 60-80. Infusion was stopped at the end of surgery. The time taken to reach the BIS of ≥90 was recorded as 'recovery time'. The amount of propofol consumed for onset of sedation and total amount consumed during the surgery were noted and compared. Results: There was no significant difference regarding demographic data and onset time in both groups (P>0.05). Recovery time was significantly prolonged in group-B than group-L 5.57+1.25 min and 4.38+0.94 min respectively (P<0.05). Dose of propofol consumed for onset of sedation was significantly low in group-B than group-L, 17.13+4.22 mg vs. 27.77+8.39 mg respectively (P<0.05). Total amount of propofol consumed was also significantly low in group-B than group-L, 140.33+34.59 vs. 184.80+38.21 respectively (P<0.05). Conclusion: We conclude that epidural block with 0.5% bupivacaine is associated with less propofol consumption as compared with 2% lignocaine with adrenaline to maintain BIS 60-80 and hence is more effective.
Comparison of two doses of magnesium sulphate as sedative during awake fiberoptic intubation for patients undergoing maxillofacial surgery: A prospective RCT
(Faculty of Anaesthesia, Pain and Intensive Care, AFMS, 2020) Kavita Meena; Armaanjeet Singh; Rajesh Kumar Meena; Dinesh Kumar Singh
Background and objectives: Awake fiberoptic intubation (AFI) is the technique of choice for anticipated difficult intubation via nasal/oral route depending on the type of surgery. Various anesthetic techniques have been used to facilitate AFI, including regional anesthesia, topical anesthesia and sedation. There are few studies regarding the use of magnesium sulphate for this purpose. The aim of our study was to find the efficacy of magnesium sulphate as sedative in patients with maxillofacial trauma undergoing AFI and to establish the dose that provides better sedation. Methodology: 80 patients with maxillofacial trauma scheduled to undergo open reduction and internal fixation were included in this randomized control trial. The patients were randomly divided into two groups. Group M1 received inj MgSO430 mg/kg in 100 mL NS and Group M2 received inj MgSO445 mg/kg in 100 mL NS over 10-15 min before surgery. Sedation was assessed using Ramsay Sedation Score. Result: The sedation scores were found to be higher in Group M2 as compared to Group M1, which was statistically significant (p < 0.006). On comparison of hemodynamic parameters before and after intubation, more blunting of hemodynamic response seen with 45 mg/kg MgSO4. Conclusion: Magnesium sulphate provides good sedation for awake fiberoptic intubation in patients with maxillofacial trauma, and a dose of 45 mg/kg of magnesium sulphate provides deeper sedation as compared to 30 mg/kg. © 2020 Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved.
Metabolic alkalosis: A less appreciated side effect of Imipenem-cilastatin use
(Wolters Kluwer Medknow Publications, 2013) Pragyan Swagatika Panda; Surya Kumar Dube; Suman Sarkar; Dinesh Kumar Singh
[No abstract available]
Modern Tools of Genome Engineering and Their Applications
(Springer Nature, 2023) Rajinder Kaur; Ashish Kumar Singh; Dinesh Kumar Singh; Samer Singh
Genome editing systems have emerged as an advanced bioengineering tool capable of targeting and editing the genomes of almost all organisms in a sequence-specific manner. This chapter presents an overview of the leading developments in the modern tool armory for genome editing that meet the high standards of efficiency, safety, and accessibility in genome engineering, i.e., ZFNs, TALENs, and CRISPR. These novel tools, primarily based on engineered nucleases, have proved to be one of the most effective and reliable tools for genome engineering. The engineered nucleases have enabled the alteration of targeted DNA sequences in a wide range of organisms and cell types. We will cover the mechanism and application of these methods for genome editing in current biology, functional genome screening, healthcare, agriculture, gene therapy, biological sciences, drug development, etc. General strategies used for designing specific ZFNs, TALENs, and CRISPR/Cas9 systems and analyzing their activity have been indicated. The therapeutic applications of these tools in controlling disease and their potential usage in the development of agricultural and industrial products, environmental protection, food development, immunotherapy, and treatment of genetic diseases, neurodegenerative diseases, and cancer are also briefly touched upon. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.
Penetrating injury of ascending aorta with arrow in situ
(2012) Siddharth Lakhotia; Shashi Prakash; Dinesh Kumar Singh; Ashok Kumar; Debasish Panigrahi
Penetrating injuries of the aorta are rare and highly lethal; very few patients are able to reach the hospital alive. We report a case of penetrating injury into the ascending aorta with the arrow still in situ, shot by a bow in a tribal region of India. The wound of entry into the aorta was sealed by the arrow itself. The patient came to us walking and supporting the arrow with his left hand. He was operated on, and the arrow was successfully removed from the aorta. © 2012 The Society of Thoracic Surgeons.
Release pattern of available phosphorus and sulphur at constant moisture regime in different soils
(IndianJournals.com, 2015) Harish Kumar Singh; Surendra Singh; Dinesh Kumar Singh
[No abstract available]
Syringe swap and similar looking drug containers: A matter of serious concern
(2013) Ghanshyam Yadav; Surender Kumar Gupta; Alok Kumar Bharti; Sandeep Khuba; Gaurav Jain; Dinesh Kumar Singh
Medication error is a leading cause of morbidity and mortality in anesthesia and critical care unit. We present a case report of a 25 years old female patient, scheduled for emergency lower segment caesarean section (LSCS) under spinal anesthesia. Due to a syringe swap, inj. thiopentone sodium was injected inadvertently, instead of inj. ceftazidime. We had to administer general anesthesia to ventilate the patient, the patient which was otherwise unnecessary in this case. Patient was successfully extubated and shifted to postoperative anesthesia recovery room. We present a second case report of a 45 years old male patient with chronic obstructive pulmonary disease (COPD) admitted in Intensive Care Unit (ICU). This patient inadvertently received atropine instead of metronidazole and was successfully managed. These incidents highlight the importance of proper drug location, double checking of the drugs, and proper anesthesia resident education.
The role of levosimendan in acute aluminum phosphide induced myocardial toxicity
(Informatics Publishing Limited and The Society of Toxicology, 2015) Bikram Kumar Gupta; Ghanshyam Yadav; Amiya Kumar Barik; Shailaja Shankar Behera; Dinesh Kumar Singh; Neeraj Kumar
Acute aluminum phosphide poisoning (AAlPP) or celphos is one of the most commonly used poisons for suicidal purpose. Number of cases reported to the hospital represents only the tip of an iceberg. Most of the patients succumb to this poison due to inadequate or lack of treatment. In our case, we added levosimendan to the already established treatment guidelines for AAlPP poisoning and we got surprising result as we could discharge the patient from our Intensive Care Unit in just 2 days with all vitals stable.