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Background: In prolonged pressure-controlled ventilation, the choice between the i-gel supraglottic airway device and cuffed tracheal tube remains debated regarding efficacy and safety. This study aims to compare the efficacy and safety of the i-gel versus cuffed tracheal tube in prolonged pressure-controlled ventilation. Materials and Methods: A prospective randomized controlled trial was conducted among 200 adult patients requiring prolonged pressure-controlled ventilation. Patients were randomly allocated into two groups: the i-gel group (n=100) and the cuffed tracheal tube group (n=100). Efficacy was assessed through airway sealing pressure, ventilatory parameters, and incidence of airway-related complications. Safety was evaluated based on the incidence of complications such as aspiration, laryngopharyngeal injury, and post-extubation airway obstruction. Results: The mean airway sealing pressure was significantly higher in the i-gel group compared to the cuffed tracheal tube group (p < 0.001). Ventilatory parameters, including tidal volume and peak airway pressure, did not significantly differ between the two groups (p > 0.05). The incidence of airway-related complications was lower in the i-gel group (12%) compared to the cuffed tracheal tube group (20%). Safety outcomes showed a lower incidence of aspiration, laryngopharyngeal injury, and post-extubation airway obstruction in the i-gel group compared to the cuffed tracheal tube group. Conclusion: In prolonged pressure-controlled ventilation, the i-gel supraglottic airway device demonstrates superior efficacy in terms of airway sealing pressure and lower incidence of airway-related complications compared to the cuffed tracheal tube. Additionally, the i-gel exhibits comparable safety profiles, suggesting its potential as a viable alternative in such settings. [ABSTRACT FROM AUTHOR]

Background: Drug-induced liver injury (DILI) is a significant cause of morbidity and mortality worldwide. Understanding the spectrum of DILI in tertiary hospitals is essential for effective management and prevention strategies. Materials and Methods: A retrospective analysis was conducted on patients diagnosed with DILI admitted to a tertiary hospital between January 2018 and November 2023. Demographic data, implicated drugs, clinical presentation, laboratory findings, and outcomes were analyzed. Results: Among 250 patients diagnosed with DILI, the mean age was 52 years, with a slight male predominance (55%). The most commonly implicated drug classes were antibiotics (32%), nonsteroidal anti-inflammatory drugs (NSAIDs) (25%), and herbal supplements (18%). Clinical presentation varied widely, with jaundice (65%), fatigue (52%), and abdominal pain (45%) being the most common symptoms. Laboratory investigations revealed elevated alanine transaminase (ALT) (mean: 856 U/L), aspartate transaminase (AST) (mean: 724 U/L), and total bilirubin (mean: 8.5 mg/dL). Liver biopsy was performed in 40% of cases, showing patterns consistent with hepatocellular injury (45%), cholestatic injury (35%), and mixed injury (20%). Management included discontinuation of the offending agent (100%), supportive care, and, in severe cases, liver transplantation (5%). Mortality rate was 8%. Conclusion: DILI presents with diverse clinical manifestations and laboratory findings. Prompt recognition, withdrawal of the offending agent, and supportive care are crucial in management. A multidisciplinary approach involving hepatologists, pharmacists, and clinicians is necessary for optimal patient outcomes. [ABSTRACT FROM AUTHOR]