Shalendra Singh

thin film bilayers grown by pulsed laser ablation deposition

We have grown superconducting thin films of (Y-123) on (PCMO) buffer layers and PCMO overlayers on Y-123 thin films using pulsed laser ablation deposition. For both sets of films below 50 K, the Y-123 layer is superconducting and the zero-field cooled PCMO layer is insulating. The application of a magnetic field of 8 T results in an insulator - metal transition in the PCMO layer. This field-induced conducting state is stable in zero magnetic field at low temperature. The PCMO layer can be returned to an insulating state by annealing above 100 K. This opens the way for the construction of devices incorporating these oxide materials in which the electronic properties of key components such as the substrate or the barrier layer can be switched in a controlled way by the application of a magnetic field.

Validity of Pulse Pressure Variation (PPV) Compared with Stroke Volume Variation (SVV) in Predicting Fluid Responsiveness

OBJECTIVE Static monitors for assessing the fluid status during major surgeries and in critically ill patients have been gradually replaced by more accurate dynamic monitors in modern-day anaesthesia practice. Pulse pressure variation (PPV) and systolic pressure variation (SPV) are the two commonly used dynamic indices for assessing fluid responsiveness. METHODS In this prospective observational study, 50 patients undergoing major surgeries were monitored for PPV and SPV: after the induction of anaesthesia and after the administration of 500 mL of isotonic crystalloid bolus. Following the fluid bolus, patients with a cardiac output increase of more than 15% were classified as responders and those with an increase of less than 15% were classified as non-responders. RESULTS There were no significant differences in the heart rate (HR), mean arterial pressure (MAP), PPV, SVV, central venous pressure (CVP) and cardiac index (CI) between responders and non-responders. Before fluid bolus, the stroke volume was significantly lower in responders (p=0.030). After fluid bolus, MAP was significantly higher in responders but there were no significant changes in HR, CVP, CI, PPV and SVV. In both responders and non-responders, PPV strongly correlated with SVV before and after fluid bolus. CONCLUSION Both PPV and SVV are useful to predict cardiac response to fluid loading. In both responders and non-responders, PPV has a greater association with fluid responsiveness than SVV.

Persistent hypertensive response following dexmedetomidine infusion in a patient with cervical spinal cord injury

We report a 19-year-old male patient, an operated case of anterior cervical discectomy and fusion for traumatic C5–C6 vertebral injury, who developed persistent hypertension following dexmedetomidine infusion in the Intensive Care Unit to enable tolerance of noninvasive ventilation mask. This unusual side effect should be borne in mind when using this drug in patients with cervical spine injuries.

Single sitting of cerebral endovascular procedure causing alopecia

International Journal of Trichology / Volume 10 / Issue 3 / May‐June 2018 145 Sir, Alopecia is a common side effect of radiation therapy in cancer patients; however, alopecia following fluoroscopy‐guided endovascular procedures was not common entity until recently due to the increasing number of such procedures. We report a case of localized scalp alopecia after embolization of orbital arteriovenous malformation (AVM). A 15‐year‐old male, a known case of residual right orbital AVM, came for endovascular embolization. Apart from complaints associated with AVM, he had a sharply demarcated alopecia patch (7 cm × 5 cm) on the scalp in the occipital area [Figure 1]. It appeared following endovascular embolization of AVM done 4 weeks back. The total duration of procedure was 7 h, and the perioperative course was uneventful. The patch was skin colored, with no scarring, scaling, itching, erythema, or dermatitis.

Clinical Comparison of I-Gel Supraglottic Airway Device and Cuffed Endotracheal Tube for Pressure-Controlled Ventilation During Routine Surgical Procedures

Objective Recently, there has been a trend favouring the use of supraglottic airway devices over endotracheal tubes (ETT) during short surgical procedures. In this study, we are going to assess the suitability of one such supraglottic airway device, i-gel, for pressure-controlled ventilation (PCV) during routine surgical procedures. Methods The airway management for 60 patients was done with either i-gel (Group I) or cuffed tracheal tube (Group E) for this prospective, randomised, double-blinded study. Insertion time, number of attempts, ease of insertion and haemodynamic monitoring were recorded before, during and after insertion of these devices. Airway leak tests, leak volume and leak fraction were measured at 15, 20 and 25 cm H2O PCV, and pharyngolaryngeal morbidity was evaluated postoperatively. Results I-gel is easier to insert than a tracheal tube (p=0.0056). The increase in heart rate and MAP was higher following insertion of tracheal tube in the first few minutes (p<0.001) and subsequently became comparable between the two groups. The leak volume and leak fraction between the two groups were comparable at 15 cm H2O PCV, but significant difference was seen at 20 and 25 H2O PCV between the two groups (p=0.232, p<0.001, p<0.001). Thirty minutes later, the leak volume and leak fraction between groups were comparable at 15 cm H2O PCV (p=0.495, p=0.104) but not at 20 and 25 H2O PCV (p<0.001, p<0.001). Pharyngolaryngeal morbidity was significantly lesser in the i-gel group. Conclusion I-gel provides a reasonable alternative to cuffed ETT for pressure-controlled ventilation provided the pressures can be limited to 15 to 20 cm H2O.

A rare case of variation in the anatomical relationship between the common carotid artery and the internal jugular vein due to enlarged thyroid

How to cite this article: Umesh G, Kaur J, Annigeri R, Thilakchand KR. Sneaky leaks: Old devil, new location. Indian J Anaesth 2017;61:600-1.

Pneumothorax during percutaneous tracheostomy ― a brief review of literature on attributable causes and preventable strategies

The significant advantages of percutaneous tracheostomy over surgical (open) tracheostomy has enabled its widespread acceptability and practice in intensive care units. Over the years, various modifications in the technique of percutaneous tracheostomy has increased its safety profile and reduced the overall complication rate. However, even though it is a bedside procedure, inappropriate patient selection and poor adherence to protocols can lead to devastating complications. One such complication, namely pneumothorax, is often overlooked. In this article, we have highlighted all the possible etiologies of pneumothorax during percutaneous tracheostomy. A brief insight into some of the preventable strategies is also discussed.