The effect of primary dehydration of various levels (1, 2 and 3% body-weight deficits) on mental functions of different complexities were studied in eight heatacclimatized subjects drawn from tropical regions of India. These subjects were also studied after a bout of exercise in heat under two conditions viz., Hot Dry (45°C DB, 30% rh), and Hot Humid (39°C DB, 60% rh) at 34OC WBGT. No significant change in routine mental work was seen either under dehydration per se of any level or after subsequent exercise under heat when compared with the normal state. On the other hand, at 2 and 3% levels of primary dehydration a further reduction was noted in all the functions though it was not significant. Inter-variations in Hot Huniid and Hot D r y conditions were not significant ex&pt for more pronounced reductions in the concentration component in Hot Hdmid conditions.

Aim:To compare insertion characteristics of 2 different supraglottic devices [I-gel and Proseal laryngeal mask airway (PLMA)] and to observe any associated complications.Study Design:This prospective, randomized study was conducted in 80 patients [Group I - I-gel insertion (n = 40) and Group P - LMA Proseal insertion (n =40)] of ASA grades I/II, of either sex in the age group 18-65 years. Both groups were compared with respect to ease of insertion, insertion attempts, fiberoptic assessment, airway sealing pressure, ease of gastric tube placement, and other complications.Materials and Methods:All patients were asked to fast overnight. Patients were given alprazolam 0.25 mg orally at 10 p.m. the night before surgery and again 2 hours prior to surgery with 1-2 sips of water. Glycopyrrolate 0.2 mg, metoclopramide 10 mg, and ranitidine 50 mg were administered intravenously to the patients 45 minutes prior to the surgery. Once adequate depth of anesthesia was achieved either of the 2 devices, selected using a random computerized table, was inserted by an experienced anesthesiologist. In group I, I-gel was inserted and in patients of group P, PLMA was inserted.Statistical Analysis:Student t-test and Mann-Whitney test were employed to compare the means; for categorical variables, Chi-square test was used.Result:Mean insertion time for the I-gel (11.12 ± 1.814 sec) was significantly lower than that of the PLMA (15.13 ± 2.91 sec) (P = 0.001). I-gel was easier to insert with a better anatomic fit. Mean airway sealing pressure in the PLMA group (29.55 ± 3.53 cm H2O) was significantly higher than in the I-gel group (26.73 ± 2.52 cm H2O; P = 0.001). Ease of gastric tube insertion was significantly higher in the I-gel group (P = 0.001). Incidence of blood staining of the device, sore throat and dysphagia were observed more in PLMA group. No other complications were observed in either of the groups.

BackgroundSudden loss of airway in patients in the lateral position has always been proven to be difficult to manage with conventional laryngoscopy. We performed a randomized controlled trial to prove the success rate of ventilation and intubation in the lateral position via intubating laryngeal mask airway (ILMA).MethodsNinety patients were divided into three groups of 30 patients each, positioned supine, right lateral, and left lateral randomly. Each group comprised of both sexes of American Society of Anesthesiologists grade I and II, aged between 18-55 years with normal airway posted for surgery under general anesthesia. Patients were pre-medicated with fentanyl followed by induction with propofol and neuromuscular blockade with rocuronium. ILMA was inserted and blind tracheal intubation via ILMA was done. The success rate, time taken and the number of adjusting maneuvers used for both procedures were recorded. The data was tabulated and analyzed using ANOVA (analysis of variance), multiple 't' test and chi square.ResultsThe success rate of intubation (96%) and time taken in insertion and intubation was found to be quite similar in all the three groups.ConclusionsWe conclude that the ILMA has an important role to play in the emergency management of airways in patients in the lateral position in terms of ease, success rate and time taken.

Twenty five subjects acclimatised to heat artificially were exposed to "basic effective temperatures" (BET) of 25.0 degrees, 29.6 degrees, 32.2 degrees, 33.3 degrees and 35.0 degrees C BET under conditions of both humid and dry heat. The object of the investigation was to ascertain the nature of effects of varying degrees of heat stress on mental alertness, associative learning, reasoning ability and dual-performance efficiency. A further aim was to determine the temperature levels at which impairment of psychological functions was severe enough to be of practical concern. The duration of each exposure was four hours, during which subjects performed physical exercise followed by rest every 30 min. It was found that all the psychological functions tested were adversely affected under extreme heat, and that a significant drop in various psychological functions was seen at effective temperatures of 32.2 degrees C and 33.3 degrees C in hot-humid and hot-dry conditions respectively. It is concluded that at the same effective temperatures the magnitude of the overall effect on psychological functions under humid conditions is relatively greater than that under dry conditions.

This report describes a 35 year old male who presented with seizures after consuming 4-5 bottles of “ALL-OUT” a commercial composition of pyrethroid used as insecticides. Our case report supports authors reporting an association of pyrethroid poisoning with status epilepticus.