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Background and Aims:Left ventricular (LV) systolic dysfunction is a common cause of hemodynamic disturbance perioperatively and is associated with increased morbidity and mortality. Echocardiographic evaluation of left ventricular systolic function (LVSF) has great clinical utility. This study was aimed to test the hypothesis that LVSF assessed by an anesthetist using mitral valve E Point Septal Separation (EPSS) has a significant correlation with that assessed using modified Simpson’s method perioperatively. Methods: This prospective observational study included 100 patients scheduled for elective surgeries. Transthoracic echocardiography (TTE) was performed preoperatively within 24 hours of surgery by an anesthetist as per American Society of Echocardiography (ASE) guidelines.EPSS measurements were obtained in parasternal long?axis view while volumetric assessment of LV ejection fraction (EF) used apical four?chamber view.Bivariate analysis of EPSS and LV EF was done by testing Pearson correlation coefficient.Receiver Operating Characteristic (ROC) curve constructed to obtain area under curve (AUC) and Youden’s Index. Results: The mean value of mitral valve EPSS was 7.18 ± 3.95 mm. The calculated mean LV EF value using volumetric analysis was 56.31 ± 11.92%. LV dysfunction as per ASE guidelines is present in 28% of patients. EPSS was statistically significantly related to LV EF negatively with a Pearson coefficient of ?0.74 (P < 0.0001).AUC of ROC curve 0.950 (P < 0.0001) suggesting a statistically significant correlation between EPSS and LV EF.Youden’s index of EPSS value 7 mm was obtained to predict LV systolic dysfunction. Conclusion: Mitral valve EPSS shows a significant negative correlation with gold standard LVEF measurement for LVSF estimation. It can very well be used to assess LVSF perioperatively by anesthetists with brief training.
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Background: Problems related to sleep and poor sleep quality are important issues for medical students. Poor sleep quality is a stressing and worrying condition that can contribute to the risk factors of medical errors being made, adverse events and attention failure which has an impact on individual’s health, hence the objective of this study was to assess the sleep hygiene among post graduate medical students of KIMS, Hubballi.Methods: A cross sectional study consisting of 260 post graduates of all departments of 1st, 2nd and 3rd year were chosen by convenient sampling method. A semi-structured questionnaire which included socio-demographic data, data to assess sleep quality by Pittsburgh sleep quality index, attention performance by EPSS scale, psychological health by self reported questionnaire 20 and data regarding factors affecting sleep. Data were entered in MS excel and analysed using SPSS software version 21.0 and suitable statistical tests were applied.Results: Our study included 122 male and 138 female post graduates, it was found that sleep quality was better among males. Excessive daytime sleepiness indicating sleep loss, was assessed by using EPSS questionnaire, which showed that in our study that 63.1% have normal attention performance. Score >17 on EPSS was 4.2% which shows that it has a negative impact on sleep hygiene.Conclusions: Poor sleep hygiene may be associated with poor sleep quality and excessive day time sleepiness. Stress and regular exercise were highly associated with sleep quality, the junior post graduates have significantly poor sleep quality than the senior post graduates.
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The goals of this study were, first, to evaluate the feasibility of inducing gastric perforation with 99% alcohol injection after electrocautery (EA-method), and, second, to observe “enhanced peritoneal stripe sign (EPSS)” and other lesions upon induction of gastric perforation. Six clinically normal beagle dogs were prepared for gastric perforation using endoscopy. After gastric perforation, EPSS and other lesions on ultrasonography were observed eventually (at 0 h, 3 h, day 1, day 2, day 3, day 4, day 5, and day 6). We graded the EPSS depending on its width and number. EPSS was observed until day 4 of the examination in all the 6 dogs. The grades of EPSS were the highest at 3 h and declined gradually. Peritoneal effusion was observed in all dogs at 3 h and on day 1. Regional bright mesenteric fat was confirmed in all dogs on days 3 and 4. In conclusion, gastric perforation can be induced by EA-method. EPSS and peritoneal effusion appear at a very early stage, and regional bright mesenteric fat was identified on days 3 and 4 in almost all dogs with gastric perforation.