Background and Aims: While performing laryngoscopy during nasotracheal intubation (NTI), the tip of the advancing endotracheal tube (ETT) generally lies along the posterior pharyngeal wall. The inflation of the ETT cuff brings it anterior towards the glottis. The present study was planned to compare the intubating conditions for NTI with standard direct Macintosh laryngoscope versus C-MAC ® video laryngoscope (VL) employing ETT cuff inflation technique. Methods: This prospective randomised study was carried out on 50 patients, American Society of Anesthesiologists physical status I–II, age 18–60 years of either sex with an indication for NTI under general anaesthesia. They were randomly divided into two groups: group VL ( n = 25): C-MAC ® VL and group ML ( n = 25): Macintosh laryngoscope. The primary outcome was to compare the total duration of NTI (T), while the secondary outcomes were to compare the need for cuff inflation or assistance with Magill forceps for successful NTI, the total number of attempts to achieve successful NTI, haemodynamic effects and complications. Results: T was significantly higher in group ML than group VL ( P < 0.001). The intubation was successful with cuff inflation in all the patients in group VL, however, six patients of group ML required assistance with Magill forceps ( P = 0.022). The haemodynamic parameters were all significantly higher at 3 min in group ML in comparison to group VL. Conclusion: The cuff inflation technique when used along with C-MAC ® VL had more success rate, required lesser time and had minimal postoperative complications in comparison to the Macintosh laryngoscope.
Dear editor,We would like to thank Quesnelle et al. [1] for their article regarding engagement with question-type Facebook posts. Currently, Imperial College London does not engage with students via social media, instead it uses "Blackboard Learn" or email communications, as such we felt it appropriate to share our opinions on the topic.As students, we like to ask questions and get an instant response and agree wholeheartedly that the "fast paced, 'always accessible"' nature of social media makes it an asset [1]. However, the openness may lead to students feeling pressured to agree with friends and peers as it can be traced back to them or to prevent conflict. Using a platform that anonymises students may lead to increased honesty and allow more students to participate, whilst also reducing the effects of groupthink and conformity in online discussions. The public availability of the pages could also lead to concerns over privacy and confidentiality.We question the viability of using Facebook in the future. Only 51% of teenagers currently use Facebook, which has fallen from 71% in 2015 [2]. Websites like Instagram, Snapchat and YouTube have risen to overtake Facebook as the leading social networks. If Facebook is used in the future, this could mean that nearly half of new students would miss out on educational content, whereas all university students are given a university email address on admission making it a much more accessible way of distributing questions, facts and supplemental information.Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
The development of the specialty of emergency medicine demands a concurrent development of research in the field; training emergency departments are expected to take the lead in research production. This study aims to evaluate the research production of 14 Saudi Emergency Medicine training departments, from January 2000 to June 2016. From April to July 2016, we searched for articles published by first authors affiliated with Saudi Emergency Medicine training centers. We searched for original articles using the following search engines: PubMed, Web of Science, Embase, Ovid, Scopus, Inspec, Agency for Healthcare Research and Quality, and Cochrane Central Registers. Based on previous literature, we used certain metrics to evaluate the articles: journal’s impact factor, number of citations by Web of Science, number of citations by Google Scholar, and Altmetric score. Out of 9520 publications screened, only 76 articles were included for evaluation. The average number of publications per year was 4.7. However, it increased from two publications in year 2000 to 14 publications in 2015. Most of the publications (n = 65, 86%) were in journals with no or low IF (IF < 2). Although, there is progressive improvement in the quantity and quality of research from Saudi Emergency Medicine training departments, there should be more eff ort to reach to a higher level of research production.
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