Non-channeled Video Laryngoscopy as an Alternative to Conventional Laryngoscopy for Intubating Adult Patients in the Intensive Care Unit.

Background Endotracheal intubation in the intensive care unit (ICU) is often a risky procedure due to the emergency situation, unstable condition of the patient, and technical problems such as inadequate positioning. Several new techniques, such as video laryngoscopy, have been developed recently to improve the success rate of first-pass intubations and reduce complications. We conducted this study to compare a non-channeled reusable video laryngoscope BPL VL-02 (manufactured by BPL Medical Technologies, Bangalore, India) with a conventional laryngoscope for intubation of adult patients in the ICU. Methodology A total of 72 ICU patients were randomly allocated to be intubated with either conventional direct laryngoscopy via Macintosh blade (group A) or video laryngoscopy with BPL VL-02 (group B). All patients were intubated by the primary investigator and the assistant noted the following parameters: the total number of intubation attempts, total duration of intubation, assistance or alternative technique required, Cormack Lehane grading, and any complications. Results There was no significant difference in the Cormack Lehane grading, number of attempts, or complications between the two groups. On comparing the assistance required during intubation in patients, it was observed that four (11.11%) patients in group A and seven (19.44%) patients in group B needed backward, upward, and rightward pressure on the larynx assistance during intubation. In five (13.89%) patients in group B, Stylet was required during intubation. The difference was statistically significant (p = 0.0308). The video laryngoscopy group (group B) had a longer mean duration of intubation (64.36 ± 6.28 seconds) compared to group A (45.72 ± 11.45 seconds), and the difference was statistically significant (p < 0.0001). Conclusions Non-channeled video laryngoscope (BPL VL-02) is not a suitable alternative to conventional direct laryngoscopy with a Macintosh blade in terms of successful first-pass intubation, total duration of intubation, and assistance required.

Surveillance of Microbiological Environment of Operation Theaters.

Introduction Control of infections in the operation theater (OT) is of utmost importance. Microbiological surveillance is an effective tool for identifying and controlling infections. The purpose of this study was to investigate the prevalence rate of microorganisms in OTs, to identify the type of microorganisms, and to detect contamination of various surfaces and air of OT. Methods OTs were properly cleaned with soap and water. All surfaces were disinfected, followed by fumigation with quaternary ammonium compounds. OTs were kept closed overnight. In the morning, they were opened, and samples were collected, taking all aseptic precautions. The settle plate method was used for air sampling, and the swab method was used for surface sampling. Samples were collected from four surfaces of OTs, i.e., floor, wall, table, and light, and samples of the OT air were also collected and immediately transported to the microbiology laboratory of the institution in sterile conditions. Result A total of 1640 swab samples were taken from eight OTs, out of which 487 (29.7%) were found positive for bacterial growth. Most of them were non-pathological microorganisms such as aerobic spore-forming Bacilli and Micrococcus. Among various OTs, septic OT showed the highest bacterial growth (82 positive cultures out of 200). In the surface sampling of various OTs, aerobic spore-forming Bacilli (221/487) was the most common isolate, followed by coagulase-negative Staphylococci (74/487), and Micrococcus (67/487). General surgery, septic, and emergency OTs had maximum air bioload (97, 93, and 91 colony-forming unit (CFU)/M3, respectively). Conclusion In surface sampling of OTs, it was found that septic OT and general surgery OT were most contaminated where the patient load was high. Among all the surfaces, OT walls and tables were most contaminated with pathogenic microorganisms. The average air bioload of all OTs was ranged between 79 and 97 CFU/M3.

Non-invasive assessment of fecal progestagens and pregnancy detection in Himalayan musk deer (Moschus chrysogaster).

The Himalayan musk deer (Moschus chrysogaster), an endangered species, is facing threat of extinction globally due to severe hunting for its musk, and efforts are under way in India to breed them in captivity. However, no information is available on the reproductive cycles of the species. In this study, we aimed to standardize an enzyme immunoassay (EIA) procedure for monitoring pregnancy using fecal samples. We collected fecal samples for 12 months from five captive females maintained at the Musk Deer Research Centre, Bageshwar, Uttarakhand, India. Three of these females were observed mating and gave birth, whereas two were seen mating but did not give birth. The gestation periods for the three females were 183, 185, and 199 days, respectively. High-pressure liquid chromatography revealed the presence of immunoreactive pregnanediol-3-glucuronide (PdG), progesterone, and 5α-pregnan-3α-ol-20-one (5-alpha-pregnane) metabolites in the fecal samples. We used EIAs against progesterone, PdG, and 5-alpha-pregnane to monitor pregnancy. We found PdG EIA to be a highly accurate and sensitive assay compared with the other two assays in detecting pregnancy. We conclude that PdG EIA can be used to diagnose and monitor pregnancy in Himalayan musk deer using fecal steroid analysis, at an early stage of 3 months after mating. This study would help in conservation breeding of musk deer in captivity and in monitoring the reproductive status of the species in the wild.