ABSTRACT
Background@#Dynamic parameters used for predicting fluid responsiveness require special equipment and are minimally invasive. Therefore, recent interest in the use of carotid artery ultrasound parameters, such as carotid corrected flow time (FTc) and peak velocity variation (ΔVpeak) has grown. Therefore, we performed this systematic review and meta-analysis to assess the ability of carotid FTc and/or ΔVpeak to accurately predict fluid responsiveness. @*Methods@#We searched the PubMed and Embase databases for articles evaluating the diagnostic accuracy of carotid FTc or ΔVpeak for predicting fluid responsiveness. Two independent authors performed the search and selected studies published until May 2022. The studies were assessed for the inclusion and exclusion criteria using Rayyan (Rayyan Systems Inc., 2022). @*Results@#Ten studies (n=438) that fulfilled the inclusion criteria were selected. Studies were divided into those assessing carotid FTc and those assessing carotid ΔVpeak. Five studies (six datasets) assessed FTc. The pooled sensitivity and specificity of carotid FTc were 0.76 and 0.88, respectively. The summary receiver operating characteristic (SROC) curve for carotid FTc had an area under the curve (AUC) of 0.9092, with a Q value of 0.8412. Seven studies calculated carotid ΔVpeak. The pooled sensitivity and specificity for ΔVpeak were 0.83 and 0.81, respectively. The SROC curve had an AUC of 0.8941 and a Q value of 0.8250. @*Conclusions@#Our meta-analysis showed that both carotid FTc and ΔVpeak are useful for predicting fluid responsiveness in anesthesia and critical care settings with good specificity and sensitivity.
ABSTRACT
Purpose@#The coronavirus disease 2019 (COVID-19) pandemic has brought the world to a standstill and has exposed the lack of preparedness of most nations’ health care sys-tems. Even in usual times, palliative care has not received its fair share of recognition as an important component of patient care; instead, the emphasis is often placed on aggressive patient management. Now, with the entire medical community and decision-making committees focussed on intensive patient care, end-of-life care has taken a backseat. @*Methods@#This article is a brief communication. @*Results@#COVID 19 infection has been shown to lead to greater mortality and morbidity in patients with pre-existing illnesses such as hypertension, diabetes, renal failure, and cancer. Patients typically in need of end-of-life care, such as those with late-stage cancer or heart failure, are therefore at a higher risk of both contracting COVID-19 and suffering a more severe disease course. The strict nationwide lockdowns being imposed in most countries have deterred patients from seeking medical attention or hospice care. Every day new research is coming to light regarding COVID 19. This has helped significantly in creating awareness and limiting the spread of disease. However, misinformation is also rampant, leading to discrimination and mistreatment of infected patients. @*Conclusion@#This pandemic has been a terrifying ordeal for all and has exposed our entire population physically, psychologically, emotionally, and financially to unimaginable stresses. In the present scenario, EOL care is as much a necessity as intensive care and should be given at least a fraction of its importance.
ABSTRACT
Background: Age of a child can be assessed from various parameters such as chronological age, height, weight, secondary sexual characteristics, skeletal age, or dental age. The present study was planned to assess and compare chronological age with dental age (Demirjian's method and Willem's method) and skeletal age (Fishman's method). Materials and Methods: The present study was done on a sample of 100 children in the age group of 9–14 years. The chronological age was computed through the birth certificates and dental age was calculated from their orthopantomograms (OPGs) using Demirjian's and Willem's methods. Hand-wrist radiograph of the left hand was used to compute skeletal age using Fishman's method. Paired t-test and Pearson's correlation coefficients were calculated as a part of statistical analysis at a significance level of P < 0.01. Results: The mean chronological age among the group was 12.37 ± 1.34 years, the mean dental age by Demirjian's method was 12.36 ± 1.72 years, the mean dental age by Willem's method was 12.36 ± 1.51, and the mean skeletal age by Fishman's method was 13.03 ± 1.34 years. Out of the all methods evaluated in the study, Fishman's method of age estimation showed the least value of correlation coefficient (r = 0.728) with the chronological age, whereas Willem's method showed the maximum correlation with the chronological age (r = 0.885). Conclusion: It can be concluded from the present study that the dental age estimation evaluated by the digital OPG by both the methods, that is, Demirjian's method and Willem's method, has shown high accuracy when applied to the children of Faridabad. Skeletal maturation evaluated by Fishman's method using hand-wrist radiographs was found to overestimate the age when compared to chronological age in both the sexes.
ABSTRACT
No abstract available.