047402   SURACI N, HOYOS J, BARUQUI D, SANTANA O (Anesthesiology Dep, Mount Sinai Medical Center, Florida 33140, USA, Email: nicholas.suraci@gmail. Com) : Right ventricular outflow tract obstruction due to a leiomyosarcoma. Ann. Card. Anaesth 2020, 23 (3), 338 - 9.

A 65 - year - old female presenting with worsening dyspnea and notable weight loss were found to have a systolic murmur on physical examination. On workup with computed tomography (CT) angiogram, a solid mass was found extending from the inferior vena cava into the right ventricle. Transesophageal echocardiography demonstrated this mass extension causing right ventricular outflow tract obstruction. After surgical removal, the pathology of the mass was endometrial leiomyosarcoma.

3 illus, 4 ref

047401   SHASHIKANTH M, NICOLA S, CHEN YI, JULIAN S (Casey Hospital, Victoria, Australia, Email: smanikappa@gmail.com) : Right atrial cavernous hemangioma. Ann. Card. Anaesth 2020, 23 (3), 335 - 7.

Benign cardiac hemangiomas are rare tumors that may present in or out side of the heart, epicardium being the most common site. Echocardiography is the method of choice in diagnosing cardiac masses and though 3D TEE may seem to add exact information about the location, the time constraint in doing a comprehensive examination along with 3D rendering inside operation room may become an hindrance.

5 illus, 4 ref

047400   SHABADI R, DESAI P, CHENGODE S (Anesthesia and Intensive Care Dep, Sultan Qaboos Univ Hospital, Muscat, Sultanate of Oman, Email: drrahool@yahoo.com) : Intraoperative 2D and 3D transesophageal echocardiographic assessment of cor triatriatum with ostium secundum atrial septal defect in an adult patient . Ann. Card. Anaesth 2020, 23 (3), 332 - 4.

Cor triatriatum is a rare congenital cardiac anomaly. Majority of the cases present in the childhood with an incidence of 0.4 %. However, we report a case of cor triatrium sinister with ostium secundum atrial septal defect (ASD) in a 39 - year - old female. The intraoperative 3D transesophageal echocardiography (TEE) offers an advantage over 2D TEE in visualizing the interatrial septum and the attachments of the fibromuscular accessory membrane in the left atrium (LA), which could help in surgical decision - making in this patient.

5 illus, 4 ref

047399   ORA M, GAMBHIR S (Nuclear Medicine Dep, SGPGIMS, Lucknow - ?226 014, Uttar Pradesh, Email: gaambhir@yahoo.com) : Nuclear investigative techniques and their interpretation in the heart and vascular disease . Ann. Card. Anaesth 2020, 23 (3), 262 - 71.

Over the last several decades, myocardial perfusion imaging with single photon emission tomography and positron emission tomography has been a mainstay for the evaluation of patients with known or suspected coronary artery disease non - invasively. Technical advances in imaging modalities and radiopharmaceutical have revolutionaries the understanding of pathogenesis and management of various diseases. In this article, we shall discuss the various available imaging nuclear medicine techniques, radiopharmaceutical, and common indications. In the era of ?precision medicine,? imaging has to be patient centered. We will briefly review the upcoming areas of nuclear medicine imaging apart from perfusion imaging, such as advances in myocardial blood flow quantitation and molecular imaging.

7 illus, 1 table, 43 ref

047398   KAR P, RAMACHANDRAN G (Anesthesia and Intensive Care Dep, Nizams Institute of Medical Sciences, Hyderabad - 500 082, Telangana, Email: prachikar@yahoo.co.in) : Pain relief following sternotomy in conventional cardiac surgery: a review of non neuraxial regional nerve blocks . Ann. Card. Anaesth 2020, 23 (2), 200 - 8.

Acute post - operative pain following sternotomy in cardiac surgery should be adequately managed so as to avoid adverse hemodynamic consequences and pulmonary complications. In the era of fast tracking, adequate and efficient technique of post - operative analgesia enables early extubation, mobilization and discharge from intensive care unit. Due to increasing expertise in ultrasound guided blocks there is a recent surge in trial of bilateral nerve blocks for pain relief following sternotomy. The aim of this article was to review non - neuraxial regional blocks for analgesia following sternotomy in cardiac surgery. Due to the paucity of similar studies and heterogeneity, the assessment of bias, systematic review or pooled analysis/meta - analysis was not feasible. A total of 17 articles were found to be directly related to the performance of non - neuraxial regional nerve blocks across all study designs. Due to scarcity of literature, comments cannot be made on the superiority of these blocks over each other. However, most of the reviewed techniques were found to be equally efficacious or better than conventional and established techniques.

6 illus, 2 tables, 30 ref

047397   AGGARWAL N K, SUBRAMANIAN A (Cardiac Anesthesia Dep, Manipal Hospitals, Dwarka, New Delhi - 110 075, Email: aruncardiac@live.com) : Antifibrinolytics and cardiac surgery: the past, the present, and the future . Ann. Card. Anaesth 2020, 23 (2), 193 - 9.

Cardiac surgery is usually associated with significant blood loss, which often necessitates blood transfusion. In order to decrease the risks associated with the latter, pharmacological as well as nonpharmacological strategies have been used to reduce blood loss. Among the pharmacological approaches, antifibrinolytic drugs are the mainstay. Aprotinin, which was the first ubiquitously used drug, fell into disrepute only to re - emerge after much debate. The decline of aprotinin paved the way for the lysine analogs. However, we must be aware with the side effects of these drugs as well as the dose modification required in special situations. Nonsaccharide glycosaminoglycans have been under investigation to overcome the drawbacks of the lysine analogs. It remains to be seen whether these drugs can replace the traditional antifibrinolytics.

90 ref

047396   BHAVYA G, NAGARAJA P S, SINGH N G, RAGAVENDRAN S, SATHISH N, MANJUNATH N, KUMAR K A, NAYAK V B (Anaesthesia Dep, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore - 560 069, Karnataka, Email: naveengsingh@hotmail. Com) : Comparison of continuous cardiac output monitoring derived from regional impedance cardiography with continuous thermodilution technique in cardiac surgical patients . Ann. Card. Anaesth 2020, 23 (2), 189 - 92.

Cardiac output (CO) assessment is a corner stone in advanced haemodynamic management, especially in critical ill patients. The present study was conducted to validate cardiac index and cardiac output by NICaS? with the thermodilution technique using pulmonary artery catheter in post - operative cardiac surgical patients. This was a prospective observational clinical study conducted at a tertiary care hospital. 23 adult patients in the age range of 18 - 65 years who had undergone for elective coronary artery bypass grafting were included in the study. Spearman?s correlation coefficient of cardiac index between continuous Thermodilution (cTD) and Non - Invasive Cardiac System (NICaS?) showed a good correlation (r = 0.765, 95 % confidence interval 0.70 to 0.82, P < 0.0001). There was a good correlation between cTD and NICaS? for cardiac output (r = 0.759, 95 % confidence interval 0.69 to 0.81, P < 0.0001), Bland - Altman plot for cardiac index between cTD and NICaS? showed a mean bias of ?0.66 ? 0.6919 with limits of agreement being ?2.02 to 0.6936. Bland - Altman plot for cardiac output between cTD and NICaS? showed a mean bias of ?1.0386 ? 1.17 with limits of agreement being ?3.34 to + 1.26. Percentage error for cardiac index and cardiac output were 64.78 % and 64 % respectively. Polar plot analysis showed an angular bias of 6.32? with radial limits of agreement being ?8.114? to 20.75? for cardiac index and angular bias of 5.6682? with radial limits of agreement being ?9.1422? to 20.4784? for cardiac output. NICaS? demonstrated a good trending ability for both CI and CO. However, NICaS? derived parameters are not interchangeable with the values derived from continuous thermodilution technique.

5 illus, 11 ref

047395   ASAI O G, PRABHAKAR V, MANJUNATHA N (Anaesthesia Dep, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore - 560 069, Karnataka , Email: omshubham.asai@ gmail.com) : Comparison of upper thoracic epidural analgesia versus low thoracic epidural analgesia in off - pump coronary artery bypass graft for perioperative pain management and fast tracking . Ann. Card. Anaesth 2020, 23 (2), 183 - 8.

Upper thoracic epidural analgesia (TEA) is compared with lower thoracic epidural analgesia for the perioperative pain management and fast tracking in patients undergoing off pump coronary artery bypass grafting (OPCAB) surgery for the intraoperative hemodynamic, quality of analgesia, incentive spirometry, time to awakening & extubation and intensive care unit (ICU) duration. A prospective, randomized comparative clinical study was conducted with total of 60 patients randomized to either Group U: Upper TEA (n = 30) or Group L: Lower TEA (n = 30). Visual analog scale (VAS) was recorded in both the groups during rest and deep breathing at the various time intervals postextubation. Both the groups were also compared for intraoperative hemodynamics, incentive spirometry, time to awakening, and extubation and ICU duration. Statistical analysis was performed using the independent Student?s t - test. A value of P < 0.05 was considered statistically significant. Postextubation VAS score at rest and deep breathing at 0, 3, 6, 12, 24, 36, and 48 h were statistically significant in both groups (P ? 0.05). Incentive spirometry, time to awakening and extubation and duration of ICU stay were also statistically significant (P ? 0.05) between the groups. Lower thoracic epidural was better than upper thoracic epidural in perioperative pain management and fast tracking in OPCAB surgery.

4 illus, 5 tables, 15 ref

047394   DASTAN F, LANGARI Z M, SALAMZADEH J, KHALILI A, AQAJANI S, JAHANGIRIFARD A (Shahid Beheshti Univ of Medical Sciences, Tehran, Iran, Email: alirezajahangiri@sbmu. ac.ir) : A comparative study of the analgesic effects of intravenous ketorolac, paracetamol, and morphine in patients undergoing video - assisted thoracoscopic surgery: a double - blind, active - controlled, randomized clinical trial . Ann. Card. Anaesth 2020, 23 (2), 177 - 82.

Opioids are traditionally used as the drug of choice for the management of postoperative pain. However, their use is limited in patients undergoing Video - assisted thoracic surgery (VATS), due to their side effects, such as respiratory depression, nausea, and vomiting. In this double - blind active - controlled randomized study, we have compared the analgesic effects of ketorolac and paracetamol to morphine. Patients were randomly chosen from a pool of candidates who were undergoing VATS and were divided into three groups. During the first 24 h postsurgery, patients in the control group received a cumulative dose of morphine 20 mg, while patients in two treatment groups received ketorolac 120 mg and paracetamol 4 g in total. Doses were administered as bolus immediately after surgery and infusion during the first 24 h. Patients? pain severity was evaluated by visual analogue scale rating (VAS) at rest and during coughing episodes. The average pain score at recovery time was 2.29 ? 2.13 and 2.26 ? 2.16 for ketorolac and paracetamol, respectively, and it was significantly lower than the morphine group with an average pain score of 3.87 (P = 0.003). Additionally, the VAS score during cough episodes was significantly higher in the control group throughout the study period compared to study groups. Comparison of mean morphine dose utilized as liberation analgesic (in case of patients had VAS >3) between three groups was not significantly different (P = 0.17). Our study demonstrates the non - inferiority of ketorolac and paracetamol to morphine in controlling post - VATS pain without causing any significant side effects. We also show that ketorolac and paracetamol are superior to morphine in controlling pain during 2 h postsurgery.

1 illus, 3 tables, 30 ref

047393   CHANDRAN R, SREEDHAR R, GADHINGLAJKAR S, DASH P, KARUNAKARAN J, PILLAI V (Anesthesia Dep, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, Email: rupa@sctimst.ac.in) : Combined effect of left stellate ganglion blockade and topical administration of papaverine on left internal thoracic artery blood flow in patients undergoing coronary revascularization . Ann. Card. Anaesth 2020, 23 (2), 170 - 6.

Left stellate ganglion blockade (LSGB) may have additive effect to topical administration of papaverine on prevention of vasospasm of left internal thoracic artery (LITA). This study aims to compare LITA blood flow with topical application of papaverine alone or in combination with LSGB. Tertiary care hospital. Prospective randomized controlled study. A total of 100 patients operated for coronary revascularization were randomly and equally allocated into two groups. In control Group - C, papaverine was applied topically during the dissection of LITA. In Group - S, the additional LSGB was performed. Blood flow was measured from cut end of the LITA for 15 s. Primary objectives of the evaluation were to observe differences in the LITA blood flow. Observing incidence of radial - femoral arterial pressure difference after cardiopulmonary bypass (CPB) was secondary objective. Student?s unpaired t - test and Fisher?s exact test to find out a significant difference between the groups. LITA flow in Group - S was insignificantly more (49.28 ? 7.88 ml/min) than Group - C (47.12 ? 7.24 ml/min), (P = 0.15). Radio - femoral arterial pressure difference remained low for 40 min after termination of CPB in the Group - S compared to the Group - C (?0.99 ? 1.85 vs. ?1.92 ? 2.26). Combining LSGB with papaverine does not increase the LITA blood flow compared to when the papaverine is used alone. However, ganglion blockade reduces radial - femoral arterial pressure difference after CPB. Blockade can be achieved successfully under the ultrasound guidance without any complications.

2 illus, 2 tables, 27 ref

047392   ARASU T, RAGAVENDRAN S, NAGARAJA PS, SINGH N G, MANJUNATHA N, BASAPPANAVAR V S (Anaesthesia Dep, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru - 560 069, Email: docnag10@gmail.com) : Comparison of pectoral nerve (PECS1) block with combined PECS1 and transversus thoracis muscle (TTM) block in patients undergoing cardiac implantable electronic device insertion - a pilot study . Ann. Card. Anaesth 2020, 23 (2), 165 - 9.

Pectoral nerve (PECS1) block has been used for patients undergoing cardiac implantable electronic device (CIED) insertions, however, PECS1 block alone may lead to inadequate analgesia during tunneling and pocket creation because of the highly innervated chest wall. Transversus thoracis muscle plane (TTM) block targeting the anterior branches of T2 - T6 intercostal nerves can be effectively used in combination with PECS1 for patients undergoing CIED insertion. The present study hypothesized that combined PECS1 and TTM blocks would provide effective analgesia for patients undergoing CIED insertion compared to PECS1 block alone. Thirty adult patients between the age group of 18?85 years undergoing CIED insertion were enrolled in the study. A prospective, randomized, comparative, pilot study was conducted. A total of 30 patients were enrolled, who were randomized to either Group P: PECS1 block (n = 15) or Group PT: PECS1 and TTM blocks (n = 15). The intraoperative requirement of midazolam and local anesthetic and level of sedation by Ramsay sedation score were noted. The pain was assessed by visual analog scale (VAS) at rest and during a cough or deep breathing at 0 h, 3 h, 6 h, 12 h, and 24 h after the procedure. VAS scores at rest were significantly lower in group PT at 0, 3, 6, and 12 h postprocedure, and during cough at 0, 6, and 12 h after the procedure (P < 0.05). At 24 h, VAS scores were comparable between both groups. Intraoperative midazolam consumption was higher in group P compared to group PT (P = 0.002). Fourteen patients in group P received local anesthetic supplementation in comparison to only one patient in group PT (P = 0.0001). Thirteen patients in group P received the first rescue analgesia in comparison to three patients in group PT (P = 0.0003). Combined PECS1 and TTM blocks provide superior analgesia, reduced net consumption of local anesthetic, sedative agents, and rescue analgesics compared to PECS1 block alone in patients undergoing CIED insertion.

2 illus, 3 tables, 16 ref

047391   HAMABA H, MIYATA Y, WADA T, TOMOHIKO HAYASAKA, HAYASHI Y (Sakurabashi - Watanabe Hospital, Osaka, Japan, 530 - 0001, Email: yhayashi@anes.med. osaka - u.ac.jp) : An analysis of prior experience influencing quality of pulmonary artery catheter placement in residents . Ann. Card. Anaesth 2020, 23 (2), 161 - 4.

Prior experience may be important for successful placement of a pulmonary artery catheter (PAC). However, there is no report about the minimum number of the placement to reach acceptable technique for the catheter placement during residency.This study was designed to examine quality of the catheter placement and to assess the effect of prior experience. Prospective, observational, cohort study. This study included eight residents and one experienced staff in our hospital. We prospectively examined the performance of placement of a PAC in eight residents for the first 2 months of their training period and one staff for previous 2 years. We examined the time required for the catheter placement and probability of ventricular arrhythmias during the placement. Each resident and the staff reported approximate number of past experience of the catheter placement according to the self - statement. In addition, we continued to examine the placement of a PAC in one resident with zero experience to show his improvement. Statistical analysis was performed by Kruskal?Wallis test, Mann?Whitney test, or Fisher?s exact test as appropriate and Benjamini and Hochberg method was used for multiple comparisons. The catheter placement time and probability of the ventricular arrhythmias of two residents with zero experience of the placement were significantly larger than those of the staff. On the other hand, the placement quality of the other residents who experienced at least 20 PAC placements was not significantly different from that of the staff. The placement quality of one resident with zero experience became comparable with that of the staff after 20 placements. Our data suggested that about 20 catheter placements may be required to reach acceptable technical level for the PAC placement.

3 tables, 8 ref

047390   ELGEBALY A S, FATHY S M, ELBARBARY Y, SALLAM A A (Anesthesia Dep, Tanta Univ, Tanta, Egypt, Email: elgebaly_13@hotmail. Com) : High thoracic epidural decreases perioperative myocardial ischemia and improves left ventricle function in aortic valve replacement alone or in addition to cabg surgery even with increased left ventricle mass index . Ann. Card. Anaesth 2020, 23 (2), 154 - 60.

High thoracic epidural (HTE) may reduce perioperative tachyarrhythmias, respiratory complications and myocardial ischemia (MI) and it may increase coronary perfusion and myocardial oxygen balance through sympatholysis and pain control. The aim of this study is to investigate the benefit of HTE in patients undergoing aortic valve replacement (AVR) alone or in addition to coronary artery bypass graft (CABG). Methods: This prospective randomized controlled study was conducted on 80 patients (40 with increased left ventricular mass index (LVMI) and 40 with normal LVMI) who were equally randomised (n = 40) to receive either GA with HTE (HTE group) or GA alone (GA group). Heart rate (HR), mean arterial blood pressure (MAP) and the incidence of ischemic ECG changes were recorded. LV functions (preoperative and postoperative by transthoracic echocardiography and intraoperative by transoesophageal echocardiography) were measured preoperative, intraoperative and till 48 H postoperative. Results: There was no significant difference in the baseline values of all measurements. HR and MAP were lower, and LV functions were improved in HTE group intraoperatively and postoperatively. Ischemic ECG changes were significantly lower in HTE group; with 42.9 % intraoperative risk reduction (95 % CI: 0.195 - 0.943) and 46. 6 % postoperative risk reduction (95 % CI 0.227 - 0.952) as compared to GA group. The risk of ischemia was significantly higher in patients with increased LVMI in GA group (2.25 times compared to normal LVMI patients with 95 % CI: 1.195 - 4.236), but it wasn?t increased in HTE group. LV functions were significantly improved from the induction to 48 H postoperative in HTE group as compared to GA group. Conclusion: HTE reduced the incidence of MI and improved the LV function, even with increased LVM, in patients undergoing AVR alone or in addition to CABG.

1 illus, 4 tables, 23 ref

047389   ELGEBALY A S, FATHY S M, ELMORAD M B, SALLAM A A (and PSIC, , Tanta, Egypt, Email: elgebaly_13@hotmail. Com) : Blood transfusion and lung surgeries in pediatric age group: A single center retrospective study . Ann. Card. Anaesth 2020, 23 (2), 149 - 53.

Blood transfusion is not without harm, and recent studies suggest association between transfusion and poor outcome in critically ill patients. Although it is prescribed for many reasons based on the firm belief that blood transfusion improves oxygen carrying capacity, it carries notable adverse hazards. Importantly, lung surgeries are counted as moderate to high - risk operations and take a significant risk of blood loss. This study aims to reveal the association between blood transfusion and poor clinical outcomes and characterize the epidemiology of blood transfusion after pediatric chest surgery. Retrospective cohort study, done throughout 3 years. A total of 248 patients who underwent open thoracotomy and lung surgery and aged ?18 years were classified according to the need of intraoperative or postoperative blood transfusion into two groups: Group I (non - transfused = 130) and Group II (transfused = 118). SPSS v25 was used for analysis. Transfusion probability ranged between 42.8 % and 50 % according to type of surgery. As regard to postoperative variables, there was no significant difference between both groups regarding the duration of analgesia, allergic reactions, need of re - operation and in - hospital mortality. However, transfused group showed significant increase in duration of antibiotic, persistent postoperative fever, time to remove chest drains, ICU stays, hospital stay and pneumonia. Incidence of pneumonia had a relative risk 1.82 with transfused compared to non - transfused group. Transfusion group in pediatrics undergoing lung surgeries in our study was more prone to adverse outcomes such as pneumonia, delayed time to remove chest drains, prolonged ICU stay, and hospital stay.

4 tables, 23 ref

047388   BHAVSAR R, RYHAMMER P K, GREISEN J, JAKOBSEN C (Anesthesiology and Intensive Care Dep, Aarhus Univ Hospital, Denmark, Email: cjj@dadlnet.dk) : Fast - track cardiac anaesthesia protocols: Is quality pushed to the edge? . Ann. Card. Anaesth 2020, 23 (2), 142 - 8.

The quest for methods expediting rapid postoperative patient turnover has triggered implementation of various fast - track cardiac anaesthesia protocols. Using three different fast - track protocols in randomized controlled studies (RCT) conducted 2010 - 2016 we found minimal achievements in ventilation time together with actual and eligible length of stay in cardiac recovery unit. The comparable control group patients were evaluated in this retrospective post hoc analysis, for an association between above mentioned parameters and quality parameters, to assess whether the marginal gains have been at the expense of quality of recovery and patient comfort. 90 control patients from three RCT with comparable demographic parameters and receiving standard department treatment were evaluated using time parameters and an objective/semi - objective Intensive Care Unit (ICU) score system (IDS score). Ventilation time was statistical significant lower in latest study (C) than the early (A) and intermedium (B) studies (A=293, B=261, C=205 minutes; P=0.04). The IDS was lower at extubation and all time points in the early study compared to other studies (P< 0.001;). The average IDS in latest study were the double of previous studies at the end of observations, and marginally above the acceptable score for discharge. The postoperative morphine requirement A=15.0, B=10.0 and C=26.5 mg; P=0.002) was statistical significant higher in the latest study compared to previous studies. The implementation of strict fast - track protocols resulting in shorter ventilation time did not convert to earlier eligibility to discharge from the ICU. However, the quality of recovery appears challenged.

3 illus, 3 tables, 29 ref

047387   SAID A ELGEBALY, FATHY S M, SALLAM A A, ELBARBARY Y (Anaesthesia and PSICU Dep, , Tanta, Egypt, Email: elgebaly_13@hotmail. Com) : Cardioprotective effects of propofol - dexmedetomidine in open - heart surgery: A prospective double - blind study . Ann. Card. Anaesth 2020, 23 (2), 134 - 41.

Myocardial protection in cardiac surgeries is a must and requires multimodal approaches in perioperative period to decrease and prevent the increase of myocardial oxygen demand and consumption that lead to postoperative cardiac complications including myocardial ischemia, dysfunction, and heart failure. Prospective, controlled, randomized, double - blinded study. This study aims to study the effect of propofol - dexmedetomidine continuous infusion cardioprotection during open - heart surgery in adult patients. Sixty adult patients of both sexes aged from 30 to 60 years old belonging to the American Society of Anesthesiologists III or IV undergoing open - heart surgery were randomly divided into two equal groups: Group P (control group) received continuous infusion of propofol at a rate of 2 mg/kg/h and 50 cc 0.9 % sodium chloride solution infused at a rate of 0.4 ?g/kg/h (used as a placebo) and Group PD received continuous infusion of propofol at a rate of 2 mg/kg/h and dexmedetomidine 200 ?g diluted in 50 cc 0.9 % sodium chloride solution infused at a rate of 0.4 ?g/kg/h. Infusion for all patients started immediately preoperative till skin closure. Hemodynamic measurements of heart rate (HR), invasive mean arterial pressure, and oxygen saturation were recorded at baseline before induction of anesthesia, immediately after intubation, at skin incision, at sternotomy and every 15 min in the 1st h then every 30 min during the prebypass period then every 15 min in the 1st h then every 30 min after weaning from CPB till the end of the surgery. Serum biomarkers; cardiac troponin (cTnI) and creatine kinase - myocardial bound (CK - MB) samples were measured basally (T1), 15 min after unclamping of the aorta (T2), immediate postoperative (T3), and 24 h postoperative (T4). Intraoperative data were also recorded including the number of coronary grafts, aortic cross - clamping duration, duration of cardiopulmonary bypass (CPB), duration of surgery, and rhythm of reperfusion. Fentanyl requirement, extubation time, and length of intensive care unit (ICU) stay were also recorded for every case. There was no statistically significant differences as regard to demographic data between the studied two groups. HR and blood pressure recorded was lower in the PD group than the control group, and this difference was noted to be statistically significant. Furthermore, the PD group showed lower levels of myocardial enzymes (cTnI and CK - MB), decreased total fentanyl requirement, earlier postoperative extubation, and shorter ICU stay than the P (control) group. The use of propofol - dexmedetomidine in CPB surgeries offers more cardioprotective effects than the use of propofol alone.

2 illus, 3 tables, 28 ref

047386   SANTHOSH VILVANATHAN, BALAJI KUPPUSWAMY, SAHAJANANDAN R (Anaesthesiology Dep, Christian Medical Coll Hospital, Vellore, Tamil Nadu, Email: balooswamy @ gmail. Com) : A randomized control trial to compare thoracic epidural with intercostal block plus intravenous morphine infusion for postoperative analgesia in patients undergoing elective thoracotomy . Ann. Card. Anaesth 2020, 23 (2), 127 - 33.

The objective of the study is to compare the efficacy of Thoracic epidural with Intercostal block plus intravenous morphine infusion for postoperative analgesia in patients undergoing elective thoracotomy. This study is designed as a prospective randomized clinical trial. Christian Medical College Hospital, Vellore, India. Patients undergoing elective thoracic surgery through posterolateral thoracotomy. In Group A (TEA) patients epidural catheter was inserted at T5 - 6 level before induction of GA and analgesia was activated using 0.25 % of bupivacaine towards the end of the surgery, before chest closure and infusion of 0.1 % bupivacaine with 2 mcg/ml of fentanyl was started. In Group B (ICN) patients, an intercostal blockade of the 5 intercostal spaces was performed by the surgeon just before chest closure using 0.25 % bupivacaine and a continuous intravenous morphine infusion of 0.015 - 0.02 mg/kg/hr was started. Assessment of resting and dynamic pain intensity using Numerical rating scale and sedation using Ramsay sedation scale was done and recorded at 1, 6,12,18,24 hours during the first postoperative day. The other parameters that were measured include side effects and the requirement of rescue analgesia. Resting and Dynamic (NRS) pain scores were less in Group A (TEA) than Group B (ICN). In the first 12 hours, the differences in both the resting (P = 0.0505) and dynamic (P = 0.0307) pain scores were statistically significant. By the end of the first postoperative day, sedation scores were more or less similar in both groups. The incidence of side effects and requirement of rescue analgesia were found to be similar in both the groups. To summarize, though the results show a slightly better quality of analgesia with the thoracic epidural, the difference being clinically insignificant intercostal blockade could be considered as a valid alternative.

5 illus, 5 tables, 25 ref

047385   VOGIREDDY R. KRISHNA, PATIL N, NILESHWAR A (Anaesthesiology Dep, Kasturba Medical Coll, Manipal, Karnataka - 576 104, , Email: anitharshenoy@gmail. Com) : Prospective evaluation of the utility of CHA2DS2 - VASc score in the prediction of postoperative atrial fibrillation after off - pump coronary artery bypass surgery - an observational study . Ann. Card. Anaesth 2020, 23 (2), 122 - 6.

Off - pump coronary artery bypass (OPCAB) surgery is associated with evasion of complications of cardiac bypass. The incidence of postoperative atrial fibrillation (POAF) may also be reduced because of less ischemia and inflammation. Prospective evaluation of utility of CHA2DS2 - VASc score in the prediction of POAF after OPCAB surgery. In this prospective, observational study, 99 patients who underwent elective isolated OPCAB surgery were included. Patients with pacemaker in situ, receiving antiarrhythmic drugs preoperatively, and preexisting atrial fibrillation were excluded. A detailed history taking and physical examination were done preoperatively and the CHA2DS2 - VASc scores were calculated for each patient. They received a standard anesthetic including midazolam, fentanyl, propofol, vecuronium, and isoflurane. The number of grafts, inotrope usage, and blood product transfusion in the perioperative period were noted. Patients were followed up for 5 days after surgery for development of new onset POAF requiring treatment. About 20 of the 99 patients developed POAF. POAF occurred most commonly on postoperative day 2. They were older, more likely diabetic, had preoperative diastolic dysfunction, and received blood products perioperatively. POAF group had higher mean CHA2DS2 - VASc score (3.6 ? 0.821 vs. 2.11 ? 1.35) and had longer hospital stay (16.85 ? 8.61 vs. 12.6 ? 4.05 days) than no POAF group. The cutoff for CHA2DS2 - VASc score was 3, which showed 90 % sensitivity, 77.22 % specificity, 50 % positive predictive value, and 96.63 % negative predictive value. CHA2DS2 - VASc score is useful in predicting POAF after OPCAB surgery. Higher the CHA2DS2 - VASc score, greater is the possibility of development of POAF.

2 illus, 7 tables, 8 ref

047384   SUHRID A TRE A, JANBURE N, GADDAM N, SHINDE D, TRE S A (Anaesthesia Dep, MCRI and Mahatma Gandhi Medical College and Hospitals, Aurangabad, Maharashtra - 431 003, , Email: sannachhatre@gmail. Com) : Anesthesiologists and job satisfaction in cardiac cath lab: do we need guidelines? . Ann. Card. Anaesth 2020, 23 (2), 116 - 21.

Cardiac cath lab procedures are developing in numbers, complexities and in demands with good outcomes. The complexicity of procedures and high risk patient factors require efficient cardiac anaesthesiologist?s care. They need good infrastructure and anaesthesia facilities. These facilities may be available at Metrocity superspeciality centres, but small units at district levels may not have all these facilities. There are many issues existing which make cardiac anaesthesiologists to prefer to work only in cardiac operation theaters than cath lab. They don?t get the job satisfaction in cath lab because of higher stress levels to overcome with the lacunaes in cath lab working. We hypothesize that cath lab in various centres are run by cardiac anaesthesiologists in majority. To analyze the infrastructure and working conditions of cath lab in perspective of anaesthesiologist, we conducted this survey. Online survey among IACTA members, through email available through IACTA site. The link was https://www.surveymonkey.com/r/9FKZ3TV. We contacted 500 IACTA members through email addresses available with us. 116 members replied to the online questionnaire done using SurveyMonkey software. Total 12 questions asked and answers analysed. The identity of responders is not disclosed by Survey monkey. Results were analysed in for options in percentage wise by Surveymonkey software.we compiled all responses and categorized the suggestions by responders. Role of anaesthesiologist and anaesthesia facilities should be given important priority in cath lab units. Healthy attitude of governing members of cathlab as well as standard guidelines for recommendation of infrastructure of cath lab, monitoring and patient care is need of the hour!

1 illus, 1 table, 12 ref

047383   SUJATA N, TOBIN R, GUPTA A, GIROTRA G (Anesthesiology and Pain Management Dep, Max Super Specialty Hospital, Saket, New Delhi - ?110 017, Email: drnambiath@yahoo.com) : Wandering paravertebral catheter detected during thoracoscopy. Ann. Card. Anaesth 2020, 23 (1), 80 - 1.

We report a case of intrapleural migration of paravertebral catheter inserted under ultrasound guidance, detected during video assisted thoracoscopic surgery.

1 illus, 5 ref

047382   KHALIFA C, FOSSOUL S, MOMENI M, LACROIX V, WATREMEZ C (Anesthesiology Dep, Cliniques Univ, Brussels, Belgium, Email: celkhalifa@gmail.com) : An original backup technique to assess the correct positioning of right - sided double - lumen tubes without fiberoptic bronchoscopy: A pilot feasibility study . Ann. Card. Anaesth 2020, 23 (1), 75 - 9.

Accurate positioning of a right - sided double - lumen tube is essential but challenging due to the location and the potential obstruction of the right upper lobe bronchus. Fiberoptic bronchoscopy is, therefore, necessary but requires a specific training period for the anesthesiologist and might not always be available. We describe an original backup technique to assess the correct placement of these tubes in cases a fiberopetic bronchoscopy is lacking. Prospective pilot feasibility study with 10 adult patients scheduled for a left thoracic surgery. Operating theater in a universitary hospital. The new technique uses a fluoroscopy and an adult central venous catheter wire. The time needed to perform the new technique, its success rate and its efficacy in properly exclude the left lung were evaluated. Any oxygen desaturation episode (SpO2 <90 %) was considered. The technique was performed by two anesthesiologists with different experience in thoracic anesthesia. The success rate of our technique was 90 %, which did not depend on the anesthesiologist?s experience. The range of time to successfully place the tube in the dorsal decubitus position and subsequently in the right lateral decubitus position was respectively 1 min?6 min and 1 min?15 min. None of the patients presented any desaturation episodes. We describe an original, safe, and acceptable backup technique to properly insert right - sided double - lumen endobronchial tubes, whenever a fiberoptic bronchoscopy is not available. Moreover, this technique is easy enough to be performed by anesthesiologists with limited experience in thoracic anesthesia.

3 illus, 3 tables, 9 ref

047381   IGUIDBASHIAN J P, CHANG P H, IGUIDBASHIAN J, LINES J, MAXWELL B G (, Portland, USA, Email: bryanmaxwell@gmail. Com) : Enhanced recovery and early extubation after pediatric cardiac surgery using single - dose intravenous methadone . Ann. Card. Anaesth 2020, 23 (1), 70 - 4.

Methadone may offer advantages in facilitating early extubation after cardiac surgery, but very few data are available in the pediatric population. Community tertiary children?s hospital, retrospective case series. We performed a retrospective analysis of all pediatric cardiac surgical patients for whom early extubation was intended. A multimodal analgesic regimen was used for all patients, consisting of methadone (0.2?0.3 mg/kg), ketamine (0.5 mg/kg plus 0.25 mg/kg/h), lidocaine (1 mg/kg plus 1.5 mg/kg/h), acetaminophen (15 mg/kg), and parasternal ropivacaine (0.5 mL/kg of 0.2 %). Outcome variables were collected with descriptive statistics. A total of 24 children [median = 7 (interquartile range = 3.75?13.75) years old, 23.7 (14.8?53.4) kg] were included in the study; 22 (92 %) had procedures performed on bypass and 11 (46 %) involved a reentry sternotomy. Methadone dosing was 0.26 (0.23?0.29) mg/kg. None of the children required intraoperative supplemental opioids; 23 (96 %) were extubated in the operating room. The first paCO2 on pediatric intensive care unit admission was 51 (45?58) mmHg. Time to first supplemental opioid administration was 5.1 (3.5?9.5) h. Cumulative total supplemental opioids (in intravenous morphine equivalents) at 24 and 72 h were 0.2 (0.09?0.32) and 0.42 (0.27?0.68) mg/kg. One child required postoperative bilevel positive airway pressure support, but none required reintubation. None had pruritus; three (13 %) experienced nausea. A methadone - based multimodal regimen facilitated early extubation without appreciable adverse events. Further investigations are needed to confirm efficacy of this regimen and to assess whether the excellent safety profile seen here holds in the hands of multiple providers caring for a larger, more heterogeneous population.

2 illus, 2 tables, 9 ref

047380   VERMA S, SRINIVAS U, SATHPATHY A K, MITTAL P (Anesthesia Dep, CTOT, Hyderabad, Telangana, Email: swapnil6187@gmail. Com) : Comparison of effectiveness of tranexamic acid and epsilon - amino - caproic - acid in decreasing postoperative bleeding in off - pump cabg surgeries: a prospective, randomized, double - blind study . Ann. Card. Anaesth 2020, 23 (1), 65 - 9.

Off - pump coronary artery bypass graft (CABG) surgeries have been shown to have increased fibrinolysis due to tissue plasminogen activator release. There are no trials comparing the two available antifibrinolytics (tranexemic acid and epsilon - amino - caproic acid) in off - pump CABG surgeries. The aim of the present study was to compare the effectiveness of tranexamic acid and epsilon - amino - caproic acid with respect to postoperative bleeding at 4 and 24 hours as the primary outcome, and rate of postoperative transfusion, re - operations, complication rate, serum fibrinogen, and D - dimer levels as secondary outcomes. The study was carried out at a tertiary - level hospital between June 2017 and June 2018. It was a prospective, randomized, double - blind study. Eighty patients undergoing off - pump CABG, were randomly allocated to receive tranexamic acid or epsilon - amino - caproic acid. The patients were followed up in the postoperative period and were assessed for primary and secondary outcomes. Statistical analysis was performed using SPSS software, version 19.0 (SPSS Inc., Chicago, IL). Nonparametric data were expressed as median with interquartile range and compared using Mann?Whitney U - test, parametric data was represented as mean with standard deviation and analyzed using Student?s t - test. Nominal data were analyzed using Chi - square test. Bleeding at 4 hours did not show significant difference between groups, 180 ml (80?250) vs 200 ml (100?310). Bleeding at 24 hours was significantly lesser in tranexamic acid group as compared to epsilon - amino - caproic acid group, 350 ml (130?520) vs 430 ml (160?730) (P = 0.0022) The rate of transfusion, re - operations, seizures, renal dysfunction, fibrinogen levels, and D - dimer levels did not show significant difference between the groups. Tranexamic acid significantly reduced postoperative bleeding in off - pump CABG at 24 hours as compared to epsilon - amino - caproic - acid.

3 illus, 3 tables, 25 ref

047379   HAMID M, AKHTAR M I, AHMED S (Anaesthesia Dep, Aga Khan Univ, Karachi, Pakistan, Email: mohammad.hamid@ aku.edu) : Immediate changes in hemodynamics and gas exchange after initiation of noninvasive ventilation in cardiac surgical patients . Ann. Card. Anaesth 2020, 23 (1), 59 - 64.

Cardiac surgery is associated with pulmonary dysfunction and complications such as prolonged intubation and reintubation. Bilevel positive airway pressure (BiPAP) machine has been used in the clinical settings to improve oxygenation, reduce work of breathing, and avoid reintubation. The effect of BiPAP on cardiovascular parameters is not well established, and very few studies have targeted hemodynamic changes. The aim of the study was to assess the immediate effect of BiPAP on respiratory and hemodynamic parameters in post - cardiac surgery patients. This quasi - experimental study was done on 33 adult cardiac surgery patients. Ethical review committee approval was sought and consent was taken. All patients who were in respiratory distress with respiratory rate of >30/min and/or PaO2:FiO2 ratio of <200 were included. Hemodynamic and respiratory parameters were recorded just before and 15 min after BiPAP application. Sample size was determined on the basis of BiPAP effect on one of the variables, PaO2:FiO2 ratio. A total of 33 patients were included in the study. The average age of the patients was 60.97 ? 10.8, of which 23 (69.7 %) were males and 10 (30.7 %) females. BiPAP application leads to statistically significant improvement in ventilator parameters including SaO2 29 (87.7 %), PaO2 29 (87.8 %), PaCO2 21 (63.6 %), and PaO2:FiO2 ratio in 27 (81.8 %). Ventilatory parameters were significantly improved after BiPAP application in this study, but hemodynamic parameters showed no statistically significant change. BiPAP application was also able to decrease the need for reintubation in post - cardiac surgery patients

4 tables, 32 ref

047378   KARIM H M R, YUNUS M, DEY S (All India Institute of Medical Sciences, Raipur - ?492 099, Chhattisgarh, Email: drhabibkarim@gmail. Com) : A retrospective comparison of preoperative estimated glomerular filtration rate as a predictor of postoperative cardiac surgery associated acute kidney injury . Ann. Card. Anaesth 2020, 23 (1), 53 - 8.

Cardiac surgery - associated acute kidney injury (CSA - AKI) remains common with distressingly high mortality. Over time, risk scorings systems have been developed to predict it and preoperative low estimated glomerular filtration rate (eGFR) has been regarded as one of the predicting risk factors. The present study is aimed at assessing the relation of different ranges of preoperative eGFR with an incidence of CSA - AKI defined by the AKI network (AKIN) criteria. Files of 134 patients with eGFR of >40 cc/min/1.73 m2 body surface area (BSA) who underwent cardiac surgeries on cardiopulmonary bypass were screened for data collection. Occurrences of CSA - AKI were evaluated as per the AKIN criteria over the course of 3 postoperative days. The relationships of different ranges of preoperative eGFR with CSA - AKI were analyzed by appropriate statistical tests using Instat software and P < 0.05 was considered statistically significant. A total of 60 males and 74 females with a mean + standard deviation (SD) age of 37.98 ? 12.50 years and mean + SD preoperative eGFR of 70.20 ? 20.89 cc/min/1.73 m2 were analyzed in this study. About 49.25 % of patients suffered from CSA - AKI by the 3rd postoperative day. The crude risk of CSA - AKI in patients with eGFR 40?60 cc/min/1.73 m2 was not higher (odds ratio 0.29) as compared to patients in patients with eGFR >100 cc/min/1.73 m2. The CSA - AKI trend with different eGFR was also statistically insignificant (P > 0.05). In patients with preoperative eGFR >40 cc/min/1.73 m2 BSA, a lower preoperative eGFR (40?60 cc/min/1.73 m2) does not predict higher incidence of CSA - AKI as defined by AKIN criteria as compared to higher preoperative eGFR (>100 cc/min/1.73 m2). Lower height is independently associated with higher incidence of CSA - AKI in such patients.

6 tables, 22 ref

047377   CHAUDHARY T, OBEROI D, MEHROTRA V (Anaesthesiology Dep, SRH Univ, Jolly Grant, Dehradun, Uttarakhand, Email: drdeepakoberoi@gmail. Com) : A comparison of immediate postoperative complications in using left internal mammary artery + vein versus only vein as conduit in patients undergoing off - pump coronary artery bypass grafting . Ann. Card. Anaesth 2020, 23 (1), 48 - 52.

The objective of the study is to compare the immediate postoperative cardiac complications in patients undergoing off - pump coronary artery bypass grafting (OPCABG) using mixed (arterial and venous grafts) versus only venous grafts and to compare the requirement of packed red cell units and intra - aortic balloon pump (IABP) in both the groups. This was an observational, analytical, prospective study. Fifty new patients were included in the study. Patients diagnosed with triple - vessel coronary artery disease (CAD) undergoing OPCABG with an ejection fraction (EF) of more than 30 %. Patients who have undergone prior CABG, EF <30 %, preexisting valvular heart disease, any evidence pulmonary hypertension, preoperative IABP, any history of neurological dysfunction, left atrium size more than 5.5 cm, and history of coagulation disorder was excluded from the study. The most common immediate postoperative cardiac complication observed was atrial fibrillation followed by ventricular arrhythmias in both the groups. There was no statistically significant difference in complication rate between the two groups. Postoperative requirement of IABP and requirements of blood products were also similar in both the groups. Patients undergoing off - pump CABG have similar immediate postoperative complications irrespective of the type of conduit used.

1 table, 27 ref

047376   BURRA V, PK S, NB P, PS N, SINGH N G, N M, BASAPPANAVAR V S (Cardiovascular and Thoracic Surgery Dep, Sri Jayadeva Institute of Cardiovascular Sciences and Research, engaluru - ?560 069, Karnataka, Email: docnag10@gmail.com) : Role of urinary PO2 analysis during conventional versus conventional and modified ultrafiltration techniques in adult cardiac surgery . Ann. Card. Anaesth 2020, 23 (1), 43 - 7.

Medullary hypoxia is the initial critical event for kidney injury during cardiopulmonary bypass, and therefore urinary PO2 with its potential of detecting medullary oxygenation for its management. Therefore, we tested the role of urinary PO2 in predicting kidney injury in those undergoing conventional versus combined (conventional and modified) ultrafiltration during cardiac surgery in adults. We prospectively evaluated 32 adults between 18 and 65 years of age undergoing elective on - pump cardiac surgery with ejection fraction >35 % by conventional (group C) versus combined ultrafiltration (group CM). Urine samples were analyzed for PO2 after induction, 30 min, 3 h, and 6 h post filtration along with blood urea and serum creatinine after induction, at 6 h, 24 h, and 48 h post filtration. Demographic variables, cardiopulmonary bypass duration, flow rates, inotropic score, ventilation duration, diuretic use, and intensive care unit (ICU) stay were assessed between two groups. Both the groups (16 in each group) had comparable urinary PO2 after induction (P = 0.387) with significant decrease in group C at 30 min, 3 h, and 6 h post filtration (P < 0.05). There was a statistically significant increase in serum creatinine (mg/dL) at 48 h in group C compared with group CM (1.57 vs. 1.25, respectively; P ? 0.05). There was an increased diuretic usage and length of ICU stay in group C. Combined ultrafiltration technique had renoprotective effect in cardiac surgery analyzed by urinary PO2 levels.

2 illus, 6 tables, 22 ref

047375   SINGH N G, KUMAR K N, NAGARAJA P S, MANJUNATHA N (Cardiac Anaesthesia Dep, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Jayanagar, Bengaluru - 560 069, Karnataka, Email: karthiknarendrakumar@ gmail.com) : Portal venous pulsatility fraction, a novel transesophageal echocardiographic marker for right ventricular dysfunction in cardiac surgical patients . Ann. Card. Anaesth 2020, 23 (1), 39 - 42.

Right ventricular (RV) has a vital role in maintaining optimal tissue perfusion. Assessment of portal venous flow characteristics can be alternative and emerging technique to assess RV function. To investigate if portal venous pulsatility fraction (PF) could serve as effective and complementary tool in identifying RV dysfunction. Thirty adult patients aged 18 - 65 years undergoing cardiac surgery under general anesthesia were enrolled in study. Intraoperative transesophageal echocardiographic examination was performed. Tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (FAC), RV ejection fraction (EF), and portal vein flow pulsatility were assessed. Portal vein PF was used to quantify degree of pulsatility. Portal vein was demonstrated in 27 patients (90 %). 27 values of portal vein PF, RV EF, FAC, and TAPSE were analyzed. Portal vein PF demonstrated significant linear correlation with TAPSE (r = ?0.55, P = 0.003), RV FAC (r = ?0.44, P = 0.02), and RV EF (r = ?0.53, P = 0.004). ROC curve was constructed to calculate sensitivity and specificity of portal vein PF for assessing RV function. Portal vein PF value of ?45 % indicated RV dysfunction with sensitivity of 92.3 %, specificity of 71.4 %, positive predictive value of 75 %, and negative predictive value of 90.9 %. Area under ROC curve was 0.819 (95 % confidence interval = 0.624 - 0.939, P = 0.0006). Portal vein PF is simple and feasible method for assessment of RV function. It complements the existing echocardiographic measures to diagnose RV dysfunction.

4 illus, 2 tables, 9 ref

047374   REDDY B G, SINGH N G, NAGARAJA PS, SUBHASH S, CG P S, N M T, CHINTHA V (Anaesthesia Dep, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru - ?560 069, Karnataka, Email: docnag10@gamil.com) : Transesophageal echocardiographic evaluation of pulmonary vein diastolic wave deceleration time - as a predictor of left atrial pressure . Ann. Card. Anaesth 2020, 23 (1), 34 - 8.

The deceleration time of the pulmonary venous diastolic flow has been well - correlated with invasive pulmonary capillary wedge pressure in several studies regardless of left ventricular systolic function. This study was conducted to correlate deceleration time of pulmonary venous diastolic wave, DT(D), and left atrial pressure (LAP), obtained noninvasively from mitral early diastolic inflow velocity - to - early diastolic mitral annulus velocity ratio (E/e?), and to assess the ease of each method in patients with coronary artery disease undergoing off - pump coronary artery bypass grafting (OPCAB) by transesophageal echocardiography. Forty - five adult patients with coronary artery disease, with left ventricular ejection fraction of ?50 % posted for elective OPCAB were enrolled in the study. Forty values of LAP and DT(D) were analyzed. A significant linear correlation (r = ?0.64) was found between DT(D) and LAP. Area under the curve of DT(D) of ?183 ms for predicting elevated LAP (>15) was 0.903 (95 % confidence interval: 0.767 to 0.974, P < 0.0001). Deceleration time of pulmonary venous flow diastolic waveform, DT(D), feasible promising echocardiographic measure in determining elevated LAP and DT(D) ?183 ms predicts elevated LAP.

4 illus, 2 tables, 19 ref

047373   KAUSHIK A, @ All KAPOOR A, AGARWAL S K, PANDE S, TEWARI P, MAJUMDAR G, SINHA A, KASHYAP S, KHANNA R, KUMAR S, (Cardiology Dep, Sanjay Gandhi PGIMS, Lucknow - ?226 014, Uttar Pradesh, Email: akapoor65@gmail.com) : Statin reload before off - pump coronary artery bypass graft: Effect on biomarker release kinetics . Ann. Card. Anaesth 2020, 23 (1), 27 - 33.

Statins confer protection from ischemia/reperfusion through various pathways including pleiotropic mechanisms. Following chronic administration, activation of intrinsic cellular mechanisms causes attenuation of these pleiotropic effects. Since coronary artery bypass surgery (CABG) represents a reversible ischemia - reperfusion sequence, we assessed if statin reload is effective in patients undergoing off - pump CABG (n = 100) in limiting myocardial injury. Patients received loading dose of rosuvastatin (40 mg initiated 7 days before surgery) while nonloaded patients continued whatever statin dose they were receiving and served as controls. Cardiac biomarkers (Troponin - I, creatine kinase muscle/brain [CK - MB], and B - type natriuretic peptide [BNP]) were measured at 8, 24, and 48 h postoperatively. The primary end - point was the extent of perioperative myocardial injury (area under the curve [AUC]: AUC of each biomarker). Despite similar baseline levels, all biomarkers at 8, 24, and 48 h were significantly lower in the loaded group. The AUC for each biomarker was also significantly lower in the loaded group (cTnI 37.96 vs. 70.12 ng. hr/ml, CK - MB 229.64 vs. 347.04 ng. hr/ml, and BNP 5257.56 vs. 15606.68 pg. hr/ml, all P < 0.001). Delta cTnI (change from baseline to peak level) (1.00 ? 1.34 vs. 2.25 ? 2.59), delta CK - MB (4.54 ? 5.89 vs. 10.68 ? 9.95), and delta BNP (120.41 ? 172.48 vs. 449.23 ? 790.95) all P < 0.001 were also significantly lower in the loaded group. Those loaded with rosuvastatin had lower inotrope duration (22.9 ? 23.33 vs. 31.26 ? 25.39 h, P = 0.04) and ventilator support time (16.94 ? 6.78 vs. 23.8 ? 20.53 h, P = 0.03). In patients undergoing off - pump CABG, statin reload can ?recapture? cardioprotection in patients already on statins with favorable effect on release kinetics of biomarkers and postoperative outcomes.

6 illus, 2 tables, 20 ref

047372   KANZARIYA H, PUJARA J, KESWANI S, KAUSHIK K, KAUL V, RONAKH R, PANDYA H (Cardiac Anesthesia Dep, U. N. Mehta Institute of Cardiology and Research Centre, Ahmedabad - 380 016, Gujarat, Email: jigishajayesh@yahoo. Com) : Role of central venous - .arterial pCO2 difference in determining microcirculatory hypoperfusion in off - pump coronary artery bypass grafting surgery . Ann. Card. Anaesth 2020, 23 (1), 20-Jun.

Cardiac surgery is frequently associated with macro and microcirculatory hypoperfusion. Patients with normal central venous oxygen saturation (Scvo2) also suffer from hypoperfusion. We hypothesized that monitoring central venous - arterial pco2 difference (dCO2) could also serve as additional marker in detecting hypoperfusion in cardiac surgery patient. This is a prospective observational study. Patients undergoing off - pump coronary artery bypass grafting included in this study. The dCO2 was measured postoperatively. The patients with a ScvO2 ?70 % were divided in to 2 groups, the high - dCO2 group (?8 mmHg) and the low - dCO2 group (<8 mmHg). The 65 patient had scvO2 ?70%. Out of these, 20 patients were assigned to the high dCO2 group and 45 patients to the low dCO2 group. Patients with high dco2 had higher lactate levels after ICU admission. They also had significantly prolonged need for mechanical ventilation (14.90 ? 10.33 vs 10 ? 9.65, P = 0.0402), ICU stay (5.05 ? 2.52 d vs 3.75 ? 2.36 d, P = 0.049) and hospital stay (12.25 ? 5.90 d vs 8.57 ? 5.55 d P = 0.018). The overall rate of post - operative complications was similar in both the group. The present study demonstrates dCO2 as an easy to assess and routinely available tool to detect global and microcirculatory hypoperfusion in off - pump CABG patients, with assumed adequate fluid status and ScvO2 as a hemodynamic goal. We observed that high dCO2 (>8 mmHg) was associated with decreased DO2I, increased oxygen extraction ratio, the longer need for mechanical ventilation and longer ICU stay.

4 tables, 30 ref

047371   KAMATH A, PUNETHA P, ADITYA N DODDAMANE, CHALAM K S, TH C H (Cardiothoracic Surgery Dep, Sri Sathya Sai Institute of Higher Medical Sciences (SSSIHMS), Bengaluru, Karnataka, Email: hiremath.cs@sssihms. org.in) : Airway anomalies in cases of anomalous pulmonary venous connection - a single - center experience . Ann. Card. Anaesth 2020, 25 (1), 15-Sep.

Patients with congenital heart defects may present with concomitant defects involving other organ systems. Roughly 4 percent of this nature are airway anomalies. Presence of anomalous airways summon major challenge before the anesthesiologist, surgeon, and intensivist in the perioperative management of such patients. There is paucity of literature in the study of airway anomalies in the subset of congenital anomalous pulmonary venous connections. We present the analysis of three cases of airway anomalies in patients operated for anomalous venous drainage at our center. We hope to explicate the clinical implications and management of such rare presentations. The records of all patients who underwent surgical correction for anomalous venous return between January 2016 and January 2018 were reviewed retrospectively. The records were examined for presence of any airway issues, abnormal radiological findings, perioperative intubation or extubation issues and perioperative surgical findings. Amidst the 410 cases operated for congenital heart defects in this period, 92 were operated cases for anomalous pulmonary venous return, of which 3 patients presented with airway issues. One patient had an aberrant right tracheal bronchus with normal carina and bilateral main bronchial stenosis, the second patient had a hypoplastic left lung and the third patient had congenital lobar emphysema of the left lung. Prudent perioperative management necessitates prior evaluation and preemptive planning for airway anomalies in patients with anomalous venous return, since they can belong to the ?Malinosculation Syndrome? group, which involves anomalous communication by means of small openings between the different components of lung tissue, namely, the lung parenchyma, tracheobronchial tree, arteries, and veins.

5 illus, 2 tables, 19 ref

047370   MAIMARI M, NIKOLAOS G. BAIKOUSSIS, GAITANAKIS S, TRIANTAFILLOU A D, KATSAROS A, KANTSOS C, LOZOS V, KONSTANTINOS TRIANTAFILLOU (, Athens, Greece, Email: nikolaos.baikoussis@ gmail.com) : Does minimal invasive cardiac surgery reduce the incidence of post - operative atrial fibrillation? . Ann. Card. Anaesth 2020, 24 (1), 007 - 13.

Atrial fibrillation (AF) is the most common post - operative complication and tends to be the most common arrhythmia after cardiac surgery. The etiology and risk factors for post - operative AF are poorly understood, but older age, large left atrium, diffuse coronary artery disease, a history of AF paroxysms and in general, pre - existing cardiac conditions that cause restricting and susceptibility towards inflammation have been consistently linked with post - operative atrial fibrillation (POAF). It has been traditionally thought that post - operative AF is transient, well - tolerated, benign to the patient and self - limiting complication of cardiac surgery that was temporary and easily treated. However, recent evidence suggests that POAF may be more ?malignant? than previously thought, associated with follow - up mortality and morbidity. Several minimally invasive approaches, including the right parasternal approach, upper and lower mini - sternotomy (MS), V - shaped, Z - shaped, inverse - T, J - , reverse - C and reverse - L partial MS, transverse sternotomy and right mini - thoracotomy, have been developed for cardiac surgery operations since 1993 and have been associated with better outcomes and lower perioperative morbidity compared to full sternotomy (FS). The common goal of several minimally invasive approaches is to reduce invasiveness and surgical trauma. According to a statement from the American Heart Association (AHA), the term ?minimally invasive? refers to a small chest wall incision that does not include a FS. This review is aimed to evaluate the use of minimally invasive techniques like mini - sternotomy, mini - thoracotomy and hybrid techniques versus conventional techniques which are used in cardiac surgery and to compare the frequency of post - operative AF and its effect on post - operative complications, morbidity and mortality, after cardiac surgery operations with FS versus cardiac surgery operations with the use of minimally invasive techniques.

74 ref

047369   KOUNIS N G, KONIARI I, TZANIS G, SOUFRAS G D, DIMITRIOS VELISSARIS, HAHALIS G (Cardiology Dep, Patras Univ School of Medicine, Patras 26221, Greece, Email: ngkounis@otenet.gr) : Anaphylaxis - induced atrial fibrillation and anesthesia: Pathophysiologic and therapeutic considerations . Ann. Card. Anaesth 2020, 23 (1), 001 - 6.

Atrial fibrillation is the most common cardiac arrhythmia in western society affecting more than 35 million individuals worldwide annually. It is a common postoperative complication and may also occur spontaneously during general and local anesthesia administration. Aging, diabetes mellitus, hypertension, and cardiovascular diseases including cardiomyopathies, congenital cardiac anomalies, heart failure, myocardial ischemia, pericarditis, previous cardiac surgery, vascular disease, and valvular heart disease are some correlated factors. Beyond age, increased incidence of atrial fibrillation has been correlated to autoimmune system activation as it is the underlying mechanism of persistent atrial fibrillation development. Current research supports an association between the complement system activation and lymphocyte - pro - inflammatory cytokines release with the cardiac conduction system and atrial fibrosis. The loss of CD28 antigen from CD4+ CD28+ T lymphocytes seems to play a major role in atrial fibrillation development and prognosis. Except atrial fibrillation, a variety of additional electrocardiographic changes, resembling those with digitalis intoxication may accompany anaphylaxis and particularly Kounis syndrome. Histamine is one well - known mediator in allergic and inflammatory conditions as physiologically regulates several cardiovascular and endothelial functions with arrhythmogenic potential. The increased oxidative stress, measured by the redox potentials of glutathione, has been correlated with atrial fibrillation incidence and prevalence. The use of antazoline, a first - generation antihistamine agent used for rapid conversion of recent - onset atrial fibrillation in patients with preserved left ventricular function and for rapid atrial fibrillation termination during accessory pathway ablation denotes that anaphylaxis - induced histamine production could be the cause of atrial fibrillation at least in some instances. The anaphylaxis diagnosis in anesthesia can be challenging owing to the absence of cutaneous manifestetions such as flushing, urticaria, or angioedema. Anticoagulation for stroke prevention, rate and rhythm control medications, invasive methods such as radiofrequency ablation or cryoablation of pulmonary veins as well surgical ablation constitute the treatment basis of atrial fibrillation. Understanding the underlying mechanisms of atrial fibrillation by cardiologists, anesthesiologists and surgeons, as well as potential treatments, to optimize care is of paramount importance.

55 ref

047368   SHARUN K, BASHA M A, BANU S A, PAWDE A M, AMARPAL (ICAR - Indian Veterinary Research Institute, Izatnagar, Bareilly, Uttar Pradesh, Email: sharunkhansk@gmail.com) : Surgical management of compound diaphyseal fracture of humerus in a black kite (Milvus Migrans) . Explor Anim Med Res 2020, 10 (1), 70 - 2.

Fracture management in birds is a challenging task due to its low success rate. This is mainly because of the fact that avian bones have thinner, more brittle cortices and have pneumatic bones which are connected to air sacs. A Black Kite (Milvus migrans) was presented with the history of injured left wing due to Manjha/Manja (a sharp kind of kite flying thread) injury. Clinical and radiographic examination identified an open oblique fracture at the mid - diaphyseal area of humerus. Anaesthesia was performed by administering xylazine 5 mg/kg body weight intramuscularly which was followed by ketamine 15 mg/kg body weight intramuscularly. Following the aseptic preparation of surgical site, a 1.5 mm K - wire was inserted in a retrograde manner to fix the fractured bone fragments into apposition. Muscle and skin incisions were closed in standard manner. Post - operatively the wing was immobilised by bandaging. The bird was treated with antibiotics and anti - inflammatory drugs for five days. The Kite recovered uneventfully.

3 illus, 9 ref

047367   ISSA N A, MIKAEEL F B, SHAQULI A M, IBRAHIM M A, ALI S O (1Surgery and internal Medicine Dep, Univ of Duhok, Kurdistan region, Iraq, Email: nawzat.issa@uod.ac) : Seroprevalence of toxoplasma gondii in free - range local birds in Sumel District, duhok province, Iraq . Explor Anim Med Res 2020, 10 (1), 55 - 9.

In the present study, Direct Latex Agglutination Test (DLAT), Modified Agglutination Test (MAT) and enzyme - linked immunosorbent assay (ELISA) were used to detect the immune responses to Toxoplasma gondii (T. gondii) among free - range local birds (chicken, turkey, geese and ducks) in Sumel District of Duhok province, Iraq. The data revealed the overall seropositive rates of 62.2 %, 33.3 % and 21.1 % by DLAT, MAT and ELISA, respectively. Non - significant differences were found between the prevalence rates among the tested birds indicating that all birds? species to be susceptible for infection. The highest antibodies titers in response to T. gondii were found in chicken sera which was significantly higher (p < 0.05) than that in ducks. The data indicated that free - range local birds could be considered as important sources of toxoplasmosis for the locals in Duhok area. Preventative measurements should be taken to contain the further prevalence of the disease among the locals, namely pregnant women.

1 illus, 1 table, 32 ref

047366   DAS S, WAHLANG L, KHAN S, KARAM A, MILTON A, SURESH K P, PRASAD C B, VISE E, SHAKUNTALA I, SANJUKTA R, GHATAK S (ICAR Research Complex for NEH Region, Umiam, Meghalaya 793103, Email: drsamirvph@yahoo.com) : Sero - prevalence of the neglected zoonoses of porcine erysipelas in the North Eastern Hill State of Meghalaya, India . Explor Anim Med Res 2020, 10 (1), 60 - 4.

Erysipelothrix rhusiopathiae is a zoonotic bacterial pathogen of porcine origin. It can cause systemic bacterial infection leading to erysipelas on skin, arthritis, endocarditis in both pigs and human beings. The state of Meghalaya had recorded few zoonotic diseases viz., Brucellosis, Scrub typhus, Japanese encephalitis, Bird flu, Salmonellosis, Listeriosis, Colibacillosis, Swine erysipelas etc. The state had earlier reported laboratory confirmed outbreak of E. rhusiopathiae in the year 2012, which was followed by a pilot scale sero - prevalence study in pigs in two representative districts of Meghalaya. However, during 2018 - 19 a systematic sero - survey was carried out for this important zoonotic disease in swine population of Meghalaya. In the present study, a total of 515 random serum samples were collected across Meghalaya which were screened for porcine E. rhusiopathiae with reputed commercial indirect ELISA kits and the screening result showed a sero - prevalence of 0.97%. The presence of this zoonotic pathogen warrants attention from not only the veterinary department in term of disease reporting, prevention and control but also from the medical fraternity to report human cases from the state.

21 ref

047365   YADAV B S, NIYOGI D, GUPTA R K, SINGH S V, SAIF M, JAISWAL S K (Veterinary Pathology Dep, Acharya Narendra Deva Univ of Agriculture and Technology, Kumarganj, Ayodhya - 224 229, Email: rakeshguptaa96@gmail.com) : Incidence and clinico - pathological study of gout in broiler birds of Faizabad and Sultanpur districts of eastern Uttar Pradesh . Explor Anim Med Res 2020, 10 (1), 88 - 91.

The study was conducted in 12 different private and commercial broiler flocks for one year. Out of 23906 broiler birds examined, 1714 were clinically found to be naturally affected with gout, the incidence and mortality of gout being 7.17 % and 4.37 % respectively. The highest prevalence of this disease was recorded during colder months (833, 9.68 %, 439, 7.06 %) followed by summer (384, 5.40 %) and lowest in rainy season (58, 2.92 %). Of the susceptible age of first three weeks, the incidence was more during second week (9.96%), followed by first (7.63 %) and third week (6.01 %) of age. Out of the 12 flocks which were screened for gout 10 flocks were of cob breed (83.34 %), one flock of Hubbard (8.33 %) and one of Kasila breed (8.33 %). The birds affected with gout had a significant (P=0.01) increase in serum uric acid (34.42 ? 1.10). The levels of serum creatinine were significantly (P>0.01) increased (2.14 ? 0.02). The mean values of TLC and PCV in the affected birds were significantly (P>0.01) high. TEC and Hb were also significantly (P>0.05) higher than control birds.

2 illus, 1 table, 24 ref

047364   NAUTIYAL S, RAI V, BHAT S, KUMAR R, RATHER M M, SANKAR M (ICAR - Indian Veterinary Research Institute, Bareilly, Uttar Pradesh, Email: roger.vish@gmail.com) : . Explor Anim Med Res 2020, 10 (1), 18 - 23.

Since the first report of its existence emerged in the early 1990s, i - motif DNA has gained much interest among the other non - canonical DNA structures in recent years. It is a quadruplex structure made up of two parallel duplexes formed by folding of cytosine - rich sequences of the nucleic acid with the cytosine?cytosine+ base pair as its building block. Earlier known to exist only at acidic pH, genomic sequences that form stable i - motif structures even at neutral pH under certain conditions have been reported recently. It is visible during G1 stage of cell cycle and is also seen in promoter sites and in telomeres. It is the only known nucleic acid structure involving systematic base intercalation. Owing to its sharp, fast and reversible pH - driven conformational changes it has already inspired the designs of various nanomachines and has got wide applicability in fields of nanotechnology and analytical chemistry. Its recent confirmation in vivo has given insight to its potential role in various important biological processes like replication, regulation of oncogene expression, and telomere functions. Therefore, the targeting of i - motif DNA and active search for appropriate ligands interacting with this non - canonical structure is an emerging area of research in medicinal and nucleic acid chemistry.

2 illus, 30 ref

047363   SASAN J S, SARMA K, SURI S (F.V.Sc & A.H, R.S Pura, Jammu & Kashmir, Email: jssasan216@gmail.com) : Gross and morphometrical studies on scapula of stump - tailed macaque (Macaca Arctoides) . Explor Anim Med Res 2020, 10 (1), 75 - 9.

The scapula was a flat triangular bone with three borders, three angles and two surfaces. Dorsal border was slightly convex and undulating whereas cranial border was much convex and thinner and ended up distally forming a distinct notch. Posterior border was thick and straight in distal 2/3rd whereas the proximal 3rd was rounded. It presented a distinct groove in the distal 2/3rd. The cranial angle was indistinct. The distal extremity was composed of the elongated glenoid cavity, well developed tuber scapulae and massive coracoid process which was bent postero - medially. The lateral surface was unequally divided by scapular spine into supra - spinous and infra - spinous fossae. The infra - spinous fossa was triangular in outline. The scapular spine ended in a well developed acromion process which was bent cranially. The medial surface lodged a nutrient foramen at its distal part. The maximum length of scapula along the spine (without scapular cartilage) was 7.95 cm for right scapula and 8.04 cm for the left. The maximum width of scapula was 6.35 cm for right scapula and 6.37 for left scapula. The scapular index was 79.8 for the right scapula and 79.22 for the left one. The total length of scapular spine was 8.53 cm and 8.49 cm for right and left scapulae, respectively. The ratio of supra - spinous to infra - spinous fossa was 1:3.4 for right scapula and 1:3.5 for left scapula.

3 illus, 1 table, 16 ref

047362   FARAYOLA E B, ADENIKE O, AKIOYE O (Veterinary Surgery & Radiology Dep, Univ of Ibadan, Nigeria, Email: bukunmi.farayola@gmail.com) : Gross anatomy and histomorphology of testes in New Zealand white rabbit . Explor Anim Med Res 2020, 10 (1), 80 - 3.

The present study investigated the gross and histological description of the rabbit testes with the histomorphometrical indices of the testes. Four male intact New Zealand white rabbits were procured with average weight of 1.35 ?0.13kg and were housed in individual cages at the animal house of the Faculty of Veterinary Medicine, University of Ibadan. Gross pictures and measurements of the testes were recorded while the testes tissues were processed for histology and histometric assessment of seminiferous tubules. Results showed that gross measurement of the right testis were about 2.88cm in length and 0.61cm in breadth. The measurement of the left testis were about 2.65cm and 0.65cm. The average histomorphometrical readings for the seminiferous tubular diameter and seminiferous epithelial height were 265.84?m and 204.09?m respectively. The histological slides revealed normal testicular architecture in the rabbits.

3 illus, 2 tables, 18 ref

047361   CHAUDHARY R N, NIWAS R, KUMAR S (Veterinary Surgery and Radiology Dep, Lala Lajpat Rai Univ of Veterinary and Animal Sciences, Hisar, Haryana, Email: drskgvet@gmail.com) : Femoral head ostectomy in a dog suffering from hip dysplasia. Explor Anim Med Res 2020, 10 (1), 73 - 4.

Femoral Head Ostectomy (FHO) is the surgical removal of head and neck of femur. A nine - month - old dog was reported with complaint of lameness. On clinical and radiographic examination, it was diagnosed as hip dysplasia of right hip joint. FHO was performed as palliative treatment. Two months after treatment dog was moving without signs of pain.

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047360   SINGHA A, CHAKRABORTY M, DAS B, CHOWDHURY S, SARKAR S N, ROY B B (Institute of Animal Health & Veterinary Biologicals (R&T), Belgachia Road, Kolkata - 700 037, Email: drsumit07@rediffmail.com) : Epidemiological investigation of anthrax outbreak in west Bengal by microscopy, cultural and molecular techniques . Explor Anim Med Res 2020, 10 (1), 84 - 7.

Outbreak investigation of anthrax was reported by microscopic, cultural and molecular techniques from blood samples from the districts of Murshidabad, Nadia, and Hooghly in West Bengal. The Blood smear staining and molecular detection techniques revels that the repeated outbreak was confirmed at Hariharpara, Domkol, Beldanga - II, and Burwan block in the distict of Murshidabad as well as adjacent Kaliganj and Tehatta - II block in Nadia.

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047358   SHIT N, VENKATA K, SASTRY H, SINGH G, MOHAN J (Uttar Banga Krishi Viswavidyalaya, Cooch Behar, West Bengal, Email: drnonigopal@gmail.com) : Effect of l - ascorbic acid and alpha - tocopherol on ovarian regression, hormonal changes and gene expression in Japanese quail during stress . Explor Anim Med Res 2020, 10 (1), 32 - 41.

L - ascorbic acid (L - AA) and ? - tocopherol (a - TP) facilitate the first line of defence and regulate neuroendocrine mechanism to optimize performance during stress but how molecular mechanism controls ovarian functions in birds are still unclear. In view of this fact, the study was aimed to appraise the effect of natural antioxidants on ovarian functions of Japanese quail during stress. One hundred and forty four Japanese quails (10weeks) were equally divided into four groups i.e. Gr I (control), Gr II (positive control), Gr III and IV (feed withdrawal). Birds from Gr II and IV received the L - AA and a - TP@250ppm each through drinking water and studied for a period of 10 days. Six birds were sacrificed each on 1, 2, 4, 6, 8 and 10 days and morphological changes were evaluated. Serum concentration of estrogen and progesterone were estimated using RIA protocol. The expression study of luteinizing hormone receptor (LHR) and progesterone hormone receptor (PHR) gene were carried out in ovary and follicles (F1, F2, F3) by Quantitative RT - PCR. The significant reduction in body weight and reproductive tracts? weight were observed in Gr III and IV though low severity was recorded in the later group. The concentration of both estrogen and progesterone hormones were significantly (P<0.05) lowered with the study period. The expression study revealed a significant (P<0.05) down regulation of LHR and PHR gene in hierarchial follicles and the magnitude of fold expression was moderate in Gr IV. This study concludes that supplementation of L - AA and ? - TP may counteract the negative impact of stress in ovarian functions and long term treatment would synchronize better neuro - endocrine and molecular mechanism in Japanese quail.

5 illus, 2 tables, 30 ref

047357   JYOTI, SINGH N K, SINGH H, RATH S S (Veterinary Parasitology Dep, Guru Angad Dev Veterinary and Animal Sciences Univ, Ludhiana, Punjab - 141 004, Email: jyoti76vet@gmail.com) : Detection of organophosphate (malathion) resistance status in hyalomma anatolicum population from Sri Muktsar Sahib District of Punjab . Explor Anim Med Res 2020, 10 (1), 50 - 4.

Resistance status against organophosphate (malathion) in Hyalomma anatolicum collected from Sri Muktsar Sahib, Punjab was estimated by adult immersion test. The engorged female ticks were immersed in progressively increasing concentrations of malathion for 2 min and mortality was recorded up to 14 days post treatment. The LC50 (95 % confidence interval [CI]) and LC95 (95 % CI) values were determined as 12364.74 (11230.5 - 13615.1) and 72379.62 (59376.2 - 88230.7) ppm, respectively with resistance factor (RF) of 28.95 (Level III resistance). The effect of malathion on reproductive parameters of treated adult female ticks viz. egg mass weight (EMW), reproductive index (RI) and percentage inhibition of oviposition ( % IO) were also studied. The slope of mean EMW (95 % CI) was - 111.1 ? 18.79 ( - 170.9 to - 51.30) and negative as with the increasing concentrations of malathion the survived ticks laid significantly (p= 0.0097) fewer eggs. The mean RI of treated ticks showed a decreasing trend and there was a significant increase (p= 0.0064) in the mean % IO in treated ticks with increasing drug concentrations.

4 illus, 2 tables, 23 ref

047356   MATIAS F B R, BACHOCO E V B, SALINAS M B S (Central Luzon State Univ, Nueva Ecija, Philippines, Email: fbrmatias@clsucvsm.edu.ph) : Crude extracts of fecal bacteria isolated from Philippine native chicken (gallus gallus domesticus) show in vitro antimicrobial activity against Escherichia Coli . Explor Anim Med Res 2020, 10 (1), 24 - 31.

The study isolated and prepared crude extracts of fecal bacteria from four known strains of Philippine native chicken. It also evaluated the antimicrobial activity of the crude extracts against E. coli as indicator bacteria and compared to selected antimicrobials using modified disc diffusion method. Fecal suspensions were plated on nutrient agar and then incubated at 37 ?C for 24 to 48 h. Colonies were purified and two distinct isolates were characterized morphologically through Gram - staining. A loopful of bacteria was inoculated in 10ml nutrient broth and incubated at 37 ?C at different time intervals (6, 12, 18 and 24 h), then centrifuged and the cell - free supernatant (crude extract) was collected. Filter paper disc was impregnated with a total of 30 ?l of crude extract and was used for antimicrobial activity testing along with three selected antimicrobial discs against E. coli. A total of 26 bacterial isolates was identified while two distinct colony morphologies were observed, and all isolates have rod shape appearance. The incubation period with the greatest number of isolates with zone of inhibition is 6 h, while the strain with the greatest number of isolates having zone of inhibition was Joloanon. All crude extracts showed significantly higher antimicrobial activity compared to these two antimicrobials except gentamicin.

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047351   PATTANAYAK S (ARD (VR &I), West Bengal, Email: pattanayak1966@gmail.com) : Succulent biomedicines - an effective way of getting protection against diseases through immunomodulation . Explor Anim Med Res 2020, 10 (2), 112 - 23.

Modulation of immunity power of the body is a very strong weapon to combat diseases. Presently, vaccination is considered as the only weapon in this field. Vaccination means introduction of some foreign antigens (generally of infective organisms) inside the body of a human or animal to stimulate the immune system of the body to develop protective power against those antigens in future. Production of protective antibodies along with sensitization of the cells engaged in this process for future fight is the main target of vaccination. The adaptive or acquired immunity section of the individuals is stimulated to perform the work through vaccination. But the other arm of the immunity system, the non - specific immunity can also be utilised to reach the same target. The non - specific defence system of the body comprises different barrier functions of the body, action of phagocytic cells, natural killer cells, T lymphocytes, modification of activities of cytokines etc. The activated non - specific immunity can also protect individuals from catching infection or can assist in reduction of severity of the disease symptoms. The succulent biomedicines, i.e., the paste, juice or seed - powder of different medicinal plant parts, collected at succulent condition from the plants can be effectively used orally in the capsular form to serve the purpose. As these plant medicines contain much more phytochemicals, both in number and quantity and work together, so expected to be more effective than the dried parts (used in contemporary Herbal Medicines) and without toxicity of isolated phytochemicals (used in research of Modern Medicine). Apart from supply of many important nutraceuticals and micronutrients, these have the ability to act as some immunomodulator by activities like antioxidation, antiviral, antibacterial etc.: protective effects on heart, liver, kidney, ling etc. as well as effects like anti - cancer, anti - diabetic etc. Such 130 reported immunomodulant plants are listed. Different bio - preservatives and bio - encapsulating materials for packaging and transportation of the succulent biomedicines under the cold chain can be arranged for their regular use.

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047350   JR S T P, BOLAMBOT S M G, LA?ADA E B (Visayas State Univ, Leyte, Philippines, Email: eblanada@vsu.edu.ph) : Prevalence of dermatophyte infection in pigs among smallholder farmers in baybay City, Leyte, Philippines and associated risk factors . Explor Anim Med Res 2020, 10 (2), 179 - 87.

The province of Leyte accounts for at least half of the swine population in Eastern Visayas, Philippines and records the highest number of slaughtered pigs within the region. Given that the majority of pigs in the region are raised by smallholder farmers and that occupational exposure to ringworm has been recorded particularly in rural pig farmers, dermatophytosis could pose a significant public health risk. This study aimed to determine the prevalence of, and risk factors involved with dermatophyte infection in pigs raised by smallholder farmers in Baybay City, Leyte. Using actual culture procedures from 384 samples, our study confirmed the presence of dermatophytes among pigs which could be used as basis for prevention and control programs in the future. While the over - all prevalence is quite low (5.47 %) with the Microsporum nanum being the most prevalent (3.91 %) followed by Trichophyton mentagrophytes (1.04 %) and finally Microsporum canis (0.52 %), it is imperative that pig farmers should improve their management practices. In particular, the use of open pit for manure disposal and the non - specific medication of pigs should be avoided.

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047349   MADARIAGA Y G, D?AZ A V, FERNANDES M C, LIMA M N M (Univ de Ciencias M?dicas de Villa Clara, Santa Clara, Villa Clara, Cuba, Email: yiselmadariaga@infomed.sld.cu) : Morphological changes in wistar rat fetuses from progenitors with sucrose - induced metabolic syndrome . Explor Anim Med Res 2020, 10 (2), 148 - 53.

Women exhibiting the components of metabolic syndrome before the pregnancy have a high risk of fetal placental dysfunction, even fetal death. Moreover, glucotoxicity has been linked to birth defects. These issues have motivated checking the possible association between a metabolic syndrome and morphological damages in the conception product. In this paper, morphological alterations produced on the fetus by the metabolic syndrome of progenitors were determined in an experimental model. The bio - model was developed in Wistar rats by supplying them with 35 % sucrose from the intrauterine stage up to eighteen weeks of age. Subsequently, crossing was performed, the pregnancy was confirmed, and blood pressure was checked. Two groups of pregnancy were formed; metabolic syndrome and healthy control. Cesarean section was performed on day twenty of gestation, in order to make the corresponding first segment studies of reproductive toxicity. Maternal parameters such as body and organ weight were assessed. Weight, crown - rump length and total number of fetuses by group, as well as skeletal and soft tissue of the fetuses were recorded. Hematoma was the main external change found, as well as there was significant decrease in fetuses? weight of metabolic syndrome parents? group. In these fetuses, the absence of Xiphoid and Sterne brae was reported as the principal developmental delays in bone tissue and no noticeable damage was observed in soft one. These results suggest that the metabolic syndrome morphologically affects the conception product.

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047347   KUMAR A, PATYAL A (Veterinary Public Health & Epidemiology, CSK HP Agricultural Univ, Palampur, Himachal Pradesh - 176 062, Email: dratul9@gmail.com) : Impacts of intensive poultry farming on ?one health? in developing countries: challenges and remedies . Explor Anim Med Res 2020, 10 (2), 100 - 11.

During the recent past, poultry sector has shown immense adaptations to meet the ever - increasing demand for safe meat and eggs. However, this growth has been accompanied by structural changes within the industry which has led to emergence of various environmental and public health concerns ranging from water, air and soil pollution to ecological imbalances, biodiversity losses and occupational health and safety hazards. This paper analyses the environmental and human health impacts of intensive poultry production and various technical strategies to mitigate these issues.

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