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Background: Patients undergoing oral and nasal surgeries are at high risk of developing emergence agitation. We hypothesised that a single dose of dexmedetomidine would reduce emergence agitation in adults during nasal or oral surgery. METHODS: This prospective, observational study was undertaken in the Department of Anaesthesiology and Critical Care, between January 2022 and December 2023 for a period of 2 years. All the relevant parameters were documented in a structured study proforma. Patients who are to undergo nasal and oral surgeries under GA were enrolled in the study. Anaesthesia was induced with Propofol 1.0-2.0 mg/kg, Fentanyl 1 mcg/kg and Vecuronium 0.1mg/kg for Endotracheal intubation. Anaesthesia was maintained with 50% Air-50% O2 and Desflurane with the MAC of 0.8-1%. These participants were divided into two groups. Group D received Dexmedetomidine @ 0.3mcg/kg/hour 5 minutes before induction and stopped at the time of reversal. Group C received NS @ 20ml/hour 5 minutes before induction and stopped at the time of reversal. Before giving premedication, patients were observed for basal heart rate (HR), basal Non-invasive blood pressure (NIBP) and Pulse oximetry (SpO2). Patients were observed intraoperatively for HR, NIBP, SpO2, etCO2, ECG at regular intervals and postoperatively for agitation by Richmond agitation sedation scale (RASS) and hemodynamic properties will be recorded at preinduction level, induction, intubation, at the time of reversal, at the time of response to verbal command, at the time of extubation and 5 minutes post-extubation. Time to respond to verbal commands and time to extubation after discontinuation of inhalational agents will also be recorded. Results: A total of 100 participants were included in the final analysis with 50(50%) were in group C and remaining 50(50%) were in group D. The mean age in group C was 41.46 ± 12.3 years, it was 41.22 ± 12.01 in group D. Among group C 32 (64%) participants were males, 18 (36%) participants were females. Among group D 26 (52%) participants were males, and 24 (48%) participants were females. The heart rate, mean systolic BP and mean diastolic BP significantly differed between two groups at different periods (P value <0.05). The total time period from the beginning of induction till the time of extubation after discontinuation of inhalational agents in group C was 6.34 ± 0.92 min, it was 8.58 ± 1.53 in group D. The mean time period to respond to verbal commands time after discontinuation of inhalational agents in group C was 7.29 ± 0.73 min, it was 10.58 ± 1.83 in group D. The difference in time periods between the groups was statistically significant (P value <0.001). The median Richmond Agitation Sedation Scale in group C was 0.50(IQR 0 to 1), it was 0(IQR-1 to 0) in the dexmedetomidine group. The difference between the two groups was statistically significant. (P value <0.001). Conclusion: Single dose of dexmedetomidine is associated with better Hemodynamic stability, time to respond to verbal commands, time to extubation after switching off the inhalational agent and lesser emergence agitation in adults. [ABSTRACT FROM AUTHOR]

This paper presents a novel hybrid intelligent system in the framework of soft computing to predict the failure of dotcom companies. The hybrid intelligent system comprises the techniques such as a Multilayer Perceptrons (MLP), Random Forest (RF), Logistic Regression (LR), Support Vector Machine (SVM), Classification and Regression Trees (CART). The dataset collected from Wharton Research Data Services (WRDS) consists of 240 dotcom companies (also known as click-and-mortar companies), of which 120 are failed and 120 are healthy. Ten-fold cross validation is performed on the data set for all the techniques considered in their stand-alone mode. Further, two hybrid techniques viz., ensembling and boosting are employed to improve the accuracies. Moreover, t-statistic is performed on the dataset for feature selection purpose and the reduced feature subset with 10 features is extracted. The reduced feature subset is tested with all the techniques and then ensembling and boosting is also done for the reduced feature subset. Results supported by Receiver Operating Characteristic (ROC) curve indicate that the important features extracted by the t-statistic based feature subset selection yielded very high accuracies for all the techniques. Furthermore, the results are superior to those reported in previous studies on the same data set. [Copyright &y& Elsevier]

The Three Phase Power Supply Phase Selector device is critical for the operation of all medical equipment, particularly medical ventilators. Because of COVID 19, the need for ventilators has increased significantly. However, hospitals in rural areas are experiencing single-phase failure and low voltage in distribution lines, which causes interruptions in ventilator operation. This paper proposes an automatic Three Phase Power Supply Phase Chooser with a Programmable Logic Controller (PLC) to keep all medical ventilators running without disruption, especially in the occurrence of single-phase failure. During a phase failure, the proposed system automatically connects the ventilator to the another available phase in a very short period. The PLC detects the restoration of the phase of the single-phase supply and automatically reconnects the ventilator to the restored phase. It also aids in maintaining an uninterrupted power supply to critical single-phase medical appliances. It also protects sensitive single-phase medical equipment from damage and burnout. This system can be used in a variety of locations where critical single-phase medical equipment must operate continuously and without disruption. The key benefit of this controller is that it is reliable, easily programmable, and flexible. [ABSTRACT FROM AUTHOR]