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Introduction: Neonates and infants are more prone to desaturation during the apnoeic period of laryngoscopy and intubation. Various options exist to reduce this risk beyond conventional preoxygenation. Aim: To assess whether continuous apnoeic oxygenation via nasal prongs during intubation can extend the safe apnoea period compared to standard management with preoxygenation alone. Materials and Methods: A randomised controlled, two-group parallel clinical study was conducted at the Department of Anaesthesiology, Vijayanagar Institute of Medical Sciences, Ballari, Karnataka, India, from July 2019 to November 2020. The study involved 63 infants aged one day to six months undergoing elective or emergency surgeries under general anaesthesia. Preoxygenation via a mask was followed by sevoflurane induction and vecuronium-induced muscle relaxation. Conventional laryngoscopy and intubation were performed in 32 infants in Group-C (Control group), while 31 infants in Group-O (Apnoeic Oxygenation group) also received oxygen (O2) via nasal prongs at 4 L/min in addition to preoxygenation. The primary outcome parameter was the time taken for desaturation by 1%. The time taken to desaturate by 2%, 3%, 4%, and 5%, as well as their incidences, lowest observed saturation, safe apnoea period, and Heart Rate (HR) trends, were also noted. Data were analysed using Statistical Package for Social Sciences (SPSS) version 20.0 and OpenEpi version 3.01. Results: Demographic and clinical parameters were comparable between the groups. The mean time for 1% desaturation was 18.33±4.3 seconds in Group-C, while all Group-O cases maintained 100% saturation during the study period. No significant difference was found in the safe apnoea period between the groups (p=0.503). The average lowest O2 saturation observed in Group-C was 98.81±1.28%, while it was 100% in Group-O. Only one infant in Group-C showed desaturation down to 95%. Both groups exhibited similar HR trends. Conclusion: Apnoeic oxygenation by nasal prongs in healthy infants helps prolong the time to desaturation and can be beneficial for those at risk of desaturation and hypoxia. [ABSTRACT FROM AUTHOR]

The Middle Jurassic (Bajocian‒Callovian) benthic foraminifera in the Jhura Dome (Kachchh, Western India) were quantitatively analyzed to reconstruct the paleoenvironment. Three distinct assemblages are identified; these are dominated by a particular benthic foraminiferal species, and include, the moderately mesotrophic and well-oxygenated Protomarssonella poddari, moderately mesotrophic and moderately oxygenated Lenticulina subalata, and the highly mesotrophic and moderately oxygenated Epistomina mosquensis–Reophax metensis. Based on species bathymetry, an inner to middle neritic (50‒100 m) depth range is inferred for the studied section. The Bathonian is marked by a carbonate-dominated moderately mesotrophic regime, whereas the Callovian is siliciclastic-dominated and reflects highly mesotrophic conditions. The changes in facies and the trophic regime are attributed to a change in climate from a hot and drier Bathonian to a cooler and wetter Callovian with a progressive increase in the terrigenous input (= nutrient input) and in reduced oxygenation of bottom waters. The Canonical Correspondence Analysis yielded sea level, Benthic Foraminiferal Oxygen Index (BFOI) and paleoproductivity as the main factors controlling the distribution patterns of the studied benthic foraminifera. Additionally, within a shallow epeiric basin and in moderately to well-oxygenated bottom water conditions, the role of nutrients and oxygen availability overrides the influence of bathymetry that at the deeper settings, played a far greater role. [ABSTRACT FROM AUTHOR]

Aims and objective. To compare the effects of Positive Pressure Ventilation (PPV) and Face Mask oxygen on arterial blood gas (ABG) parameters in children with congestive heart failure. Materials and methods. A prospective, randomized, single-blind, cross-sectional study was undertaken in eastern India’s Dr. B.C. Roy Post Graduate Institute of Pediatric Sciences PICU. From December 2014 to June 2016, single-blind randomi- zation was used to diagnose congestive heart failure in children aged 3 months to 12 years. Results. Patients receiving face mask oxygen had a mean pH of 7.2150, while those receiving NIV had a mean pH of 7.2740 (P value = 0.012, <0.05). After 6 hours, the pH improved more in the NIV group (mean pH = 7.3023) than the face mask oxygen group (mean pH = 7.2503), P value = 0.003 (<0.05). The group receiving face mask oxygen had a mean pCO2 of 54.93 at the start of the study, while the NIV group had 52.83 (P value = 0.395, >0.05). The baseline pCO2 values of the two groups were similar. After 1-2 hours of investigation, the face mask oxygen group had a mean pCO2 of 53.50, whereas the NIV group had 47.77, with a P value of 0.008 (<0.05). After 4-6 hours, the face mask oxygen group had a mean pCO2 of 50.90, while the NIV group had 46.77, with a P value of 0.001 (<0.05). Conclusion. After 6 hours of therapy, NIV improved mean pH more than face mask oxygen. NIV ventilation improved pCO2 readings more than face mask oxygen after 2 hours. The mean pCO2 drop over 4-6 hours in the NIV group was greater than in the face mask oxygen group. [ABSTRACT FROM AUTHOR]

Background: Exercise affects every system of the body and cause several changes in them and respiratory changes are most important. Changes in blood levels of oxygen are very vital during exercise. The respiratory system is most efficient in young adults and undergoes various anatomical, physiological and immunological changes with age and hence blood levels of oxygen during exercise is more affected in elderly as compared to young adults.. But increased body mass index affects respiratory system of even young adults so there blood levels of oxygen are more compromised as compared to normal BMI young adults during exercise. Objective: Under normal circumstances in the blood there is a reserve of oxygen. However, when doing exercise, the body requires oxygen in large quantities to meet the need for energy. If the level of oxygen in the blood decreases beyond the normal limit, it will be very dangerous for the body. Health risks are associated with obesity, including its effects on respiratory function. Respiratory muscle weakness in obesity has been linked to muscle weakness as a result of decreased compliance of the chest wall or reduced lung volume or can occur both. Aim: Is to study the effect exercise on SpO2 in young adults with variable BMI. Method: A comparative cross-sectional analytical study was conducted on 106 young adults in Medical College in North India. Data was collected by using self-administered questionnaire followed by anthropometric measurement. Body Mass Index (BMI) was calculated by Quetelet’s index. Oxygen saturation at rest and after 6-minutes walking test was recorded by using pulse oximeter. Data analyzed on SPSS version 20.0 and various statistical tests were applied to find the correlation and significance. Results: The students with high BMI show negative correlation with oxygen saturation (SpO2) at rest and after 6-minutes walking test. This correlation is statistically significant. Conclusion: There is more decrease in oxygen saturation (SpO2) in students with high BMI after 6-minutes walking test as compared to students with normal BMI. Weight management is recommended to young adults in order to prevent early impact of increased BMI on respiratory system. [ABSTRACT FROM AUTHOR]

Background: High-altitude (HA, 2500 m) hypoxic exposure evokes a multitude of physiological processes. The hypoxia-sensing genes though influence transcriptional output in disease susceptibility; the exact regulatory mechanisms remain undetermined in high-altitude pulmonary edema (HAPE). Here, we investigated the differential DNA methylation distribution in the two genes encoding the oxygen-sensing HIF-prolyl hydroxylases, prolyl hydroxylase domain protein 2 (PHD2) and factor inhibiting HIF-1α and the consequent contributions to the HAPE pathophysiology. Methods: Deep sequencing of the sodium bisulfite converted DNA segments of the two genes, Egl nine homolog 1 (EGLN1) and Hypoxia Inducible Factor 1 Subunit Alpha Inhibitor (HIF1AN), was conducted to analyze the differential methylation distribution in three study groups, namely HAPE-patients (HAPE-p), HAPE-free sojourners (HAPE-f) and healthy HA natives (HLs). HAPE-p and HAPE-f were permanent residents of low altitude (< 200 m) of North India who traveled to Leh (3500 m), India, and were recruited through Sonam Norboo Memorial (SNM) hospital, Leh. HLs were permanent residents of altitudes at and above 3500 m. In addition to the high resolution, bisulfite converted DNA sequencing, gene expression of EGLN1 and HIF1AN and their plasma protein levels were estimated. Results: A significantly lower methylation distribution of CpG sites was observed in EGLN1 and higher in HIF1AN (P < 0.01) in HAPE-p compared to the two control groups, HAPE-f and HLs. Of note, differential methylation distribution of a few CpG sites, 231,556,748, 231,556,804, 231,556,881, 231,557,317 and 231,557,329, in EGLN1 were significantly associated with the risk of HAPE (OR = 4.79–10.29; P = 0.048–004). Overall, the methylation percentage in EGLN1 correlated with upregulated plasma PHD2 levels (R = − 0.36, P = 0.002) and decreased peripheral blood oxygen saturation (SpO2) levels (R = 0.34, P = 0.004). We also identified a few regulatory SNPs in the DNA methylation region of EGLN1 covering chr1:231,556,683–231,558,443 suggestive of the functional role of differential methylation distribution of these CpG sites in the regulation of the genes and consequently in the HIF-1α signaling. Conclusions: Significantly lower methylation distribution in EGLN1 and the consequent physiological influences annotated its functional epigenetic relevance in the HAPE pathophysiology. [ABSTRACT FROM AUTHOR]

Introduction: Middle Ear Surgeries (MESs) are generally performed using local anaesthesia under sedation. Butorphanol and nalbuphine both are well-known synthetic opioid with agonist-antagonist characteristics. However, no reports present a direct comparison of the analgesic efficacy of these two drugs. Aim: To evaluate analgesic efficacy of intravenous butorphanol versus intravenous nalbuphine during Monitored Anaesthesia Care (MAC) in patients undergoing tympanoplasty. Materials and Methods: This randomised clinical trial was conducted at the Department of Anaesthesiology, School of Medicine, D.Y. Patil Deemed to be University, Mumbai, Maharashtra India, from March 2018 to March 2021. Total 112 adult patients, undergoing tympanoplasty, were randomly allocated into two groups. Group N received 0.2 mg/kg nalbuphine intravenous (i.v.) and group B received i.v. 0.02 mg/kg butorphanol. The patients were then evaluated for analgesic efficacy, sedation, blood pressure, Mean Arterial Pressure (MAP), Heart Rate (HR), Respiratory Rate (RR), blood oxygen levels (SpO2), Visual Analogue Scale (VAS) Score, need for intraoperative rescue sedation/analgesia, duration of action and side-effects. Results: A significant difference was observed in the patients' responses to needle prick, where only 8 (13.3%) subjects gave a vocal response in group N versus 22 (36.6%) in group B. A significant difference in the mean time of onset of pain amongst both the group was recorded (3.16±1.38 hrs in group N and 2.63±1.19 hrs in group B). A significant difference was also recorded in the mean VAS at 15th (p-value=0.012) and 30th min (p-value= 0.017). Only 7 patients (11.6%) from group N, and 12 patients (20%) from group B required rescue agent (0.5 mcg/kg/ hour dexmedetomidine injection and 75 mg diclofenac sodium injection intravenous). Conclusion: Both 0.2 mg/kg nalbuphine and 0.2 mg/kg Butorphanol provide satisfactory results in terms of analgesic efficacy, sedation, hemodynamic and respiratory parameters, albeit, nalbuphine can be coined to be superior in terms of response to pin prick and duration of action. [ABSTRACT FROM AUTHOR]

High-resolution analysis of a 3.80 m sediment core recovered from Deoria Tal, a mid-elevation lake located at 2393 m a.s.l. in the Garhwal Himalaya, documents long-term and abrupt hydroclimate fluctuations in northern India during the mid- to late Holocene. The sediment chronology, based on ten 14C dates, indicates the core spans 5200 years. Non-destructive, radiological imaging approaches (X-ray fluorescence (XRF), X-ray imaging, and CT scans) were used to assess the response of the lake system to changing hydroclimatic conditions. Variations in elemental concentrations and sediment density evidenced notable hydroclimate change episodes centered at 4850, 4200, and 3100 cal yr BP. Elevated detrital input, greater sediment density, decreased lake ventilation, and lower autochthonous productivity reflects lake deepening between 4350 and 4200 cal yr BP. An abrupt shift in elemental concentrations and sediment density indicated the onset of lake drawdown at 4200 cal yr BP and a negative hydroclimate anomaly between 4200 and 4050 cal yr BP. Lower detrital flux, decreased sediment density, increased oxygenation, and higher autochthonous productivity, reflects a reduction in lake volume between 3200 and 3100 cal yr BP. The potential link between abrupt climate change at 4200 cal yr BP and the contraction of the Indus civilization is explored. [ABSTRACT FROM AUTHOR]

Introduction: Hypoxemic Respiratory Failure (HRF) is severe arterial hypoxemia that is refractory to supplemental oxygen. Oxygen Saturation Index (OSI) can be an alternate method of diagnosing and assessing the severity of HRF as it uses Oxygen Saturation (SpO2) in place of Partial Pressure of Oxygen (PaO2) and may be utilised with reasonable sensitivity and specificity. Aim: To evaluate the correlation between Oxygen Saturation Index (OSI) and Oxygenation Index (OI) in HRF in neonates. Materials and Methods: The prospective observational study was conducted in Kempegowda Institute of Medical Sciences and Hospital, Bengaluru, Karnataka, India, from December 2016 to July 2018. Fifty neonates who were admitted to Neonatal Intensive Care Unit (NICU) and conventionally ventilated in view of HRF were included. Arterial blood gases in the first 24 hours of life and corresponding oxygen saturations and ventilator settings were recorded. OI and OSI was calculated using the standard formula and their correlation was analysed. Results: The neonates were all on first day of life at admission to NICU and were invasively ventilated due to HRF. The mean birth weight was 1.89±0.84 kg. Of the 50 neonates, 22 (44%) were preterm babies (<34 weeks), 17 (34%) belonged to late preterm group (34 weeks to 36 weeks +6days), 9 (18%) were term babies (>37 weeks), 2 neonates were extremely preterm (less than 28 weeks). In this study, OSI and OI significantly associated and correlated (p-value <0.01) with a correlation coefficient r=0.727. Area under the Receiver Operating Characteristic (ROC) curve for OSI was 0.912 which indicates that OSI is an excellent test to assess the severity of HRF. Conclusion: That OSI can be used to diagnose and assess the severity of lung disease in neonates having HRF. [ABSTRACT FROM AUTHOR]