Yudhyavir Singh - Profile on Academia.edu (original) (raw)

Papers by Yudhyavir Singh

Turkish Journal of Anaesthesiology and Reanimation

Objective: The second wave of coronavirus epidemic affected India severely. We reviewed the in-ho... more Objective: The second wave of coronavirus epidemic affected India severely. We reviewed the in-hospital deaths during the second wave at a dedicated COVID hospital to better understand the clinical characteristics of patients who died during this period. Methods: Clinical charts of all patients who were admitted and died in-hospital due to COVID-19 between 1 April 2021 and 15 May 2021 were reviewed and clinical data were analysed. Results: The total number of patients admitted to hospital and the intensive care unit was 1438 and 306, respectively. The in-hospital and intensive care unit mortality was 9.3% (134 out of 1438 patients) and 37.6% (115 out of 306 patients), respectively. Septic shock with multiorgan failure was the cause of death in 56.6% of the deceased patients (n = 73) and acute respiratory distress syndrome in 35.3% (n = 47) patients. Of the deceased, 1 patient was less than 12 years old, 56.8% were between 13 and 64 years of age and 42.5% were geriatric, that is, 65 years of age or older. There were no comorbidities in 35.1% of the deceased patients. The cause of death did not vary with the age group. Conclusion: The in-hospital and intensive care unit mortality during the second wave was 9.3% and 37.6%, respectively. There was no major age group shift in the second wave as compared to the first wave. However, a significant number of patients (35.1%) did not have any comorbidity. Septic shock with multiorgan failure was the most common cause of death followed by acute respiratory distress syndrome.

Incidence of COVID-19-associated mucormycosis in COVID-19 patients after discharge from the COVID-19 hospital

Indian Journal of Community Medicine

Indian journal of private psychiatry, Feb 10, 2023

Background: The pandemic of coronavirus disease-2019 (COVID-19) has put healthcare workers (HCWs)... more Background: The pandemic of coronavirus disease-2019 (COVID-19) has put healthcare workers (HCWs) under the immense pressure of providing care to a large number of patients with the risk of getting infected. This has resulted in the rise of severe mental health issues in them and coping with such deep stress needs certain strategies. Aim: A study was used to evaluate the coping techniques adopted by the HCWs to deal with COVID-19-related stress. Methods: A 28-item Brief-coping orientation to problems experienced (COPE) questionnaire-based cross-sectional survey was used with the HCWs directly involved in the care of COVID-19 patients in September 2020 during the peak of the first COVID-19 wave and coping strategies were analyzed as continuous variables. Result: A total of 221 HCWs completed the questionnaire of which 166 (75%) were doctors. The mean scores for adaptive strategies and maladaptive strategies were 41.56 (9.04) and 21.41 (5.6), respectively. The most employed coping strategy was acceptance (6.35 ± 1.6) and the least was substance abuse (2.33 ± 0.9). Conclusion: Of all the coping strategies, adaptive strategies were the most employed. However, females and young ones employed maladaptive strategies, indicating the need for necessary attention in them.

Comprehensive Management of the Patient With Traumatic Cardiac Injury

Anesthesia & Analgesia

Ocular adverse effects of COVID-19 vaccines: A systematic review

Journal of Family Medicine and Primary Care

Clinical characteristics, course and outcome of critically ill COVID-19 patients with previous or current TB admitted in ICU of a tertiary care COVID centre of Indian subcontinent

Lung India

Clinical characteristics of COVID-19 patients who underwent tracheostomy and its effect on outcome: A retrospective observational study

World Journal of Virology

Indian Journal of Critical Care Medicine

Background: Acute kidney injury (AKI) following severe trauma is common. However, the requirement... more Background: Acute kidney injury (AKI) following severe trauma is common. However, the requirement of renal replacement therapy (RRT) in these patients is rare and is associated with high morbidity and mortality. The primary objective of this study was to the identify odds of risk factors, in particular, hypotension at presentation, for the requirement of RRT in patients with AKI following trauma. Methods: We performed a case-control study involving patients who were admitted to the intensive care unit (ICU) at a level I trauma center for at least 24 hours. The primary outcome measure was a study of the odds of risk factors associated with the requirement of RRT in such patients. Univariate comparisons and multiple logistic regression analyses were done to identify other risk factors. Results: The presence of crush injury, sepsis, and elevated serum creatinine (sCr) on arrival were identified to be independent risk factors for RRT requirement. Hypotension and exposure to radiocontrast or nephrotoxic antimicrobials were not found to be associated with the need for RRT. Acute kidney injury requiring RRT was associated with significantly increased ICU length of stay (15 days vs 5 days; p < 0.001) and higher mortality (83% vs 35%; p < 0.001). Conclusion: The presence of crush injury, sepsis, and elevated sCr on presentation were identified to be independent risk factors while hypotension association was insignificant for AKI requiring RRT in our investigation.

Indian Journal of Critical Care Case Report

Drug reaction with eosinophilia and systemic symptoms is a complex syndrome and accounts for 10-2... more Drug reaction with eosinophilia and systemic symptoms is a complex syndrome and accounts for 10-20% of all cutaneous drug reactions in hospitalized patients. The diagnosis is primarily clinical and must be suspected in patients who have received new drug treatment in the preceding 2-8 weeks. Patients

Cureus, 2021

Pulmonary alveolar proteinosis (PAP) is a syndrome, in which surfactants get deposited slowly in ... more Pulmonary alveolar proteinosis (PAP) is a syndrome, in which surfactants get deposited slowly in alveoli, blocking the airway exchange. PAP severity also varies from mild to severe, presenting with dyspnea, cough, hemoptysis with or without fever. The radiological findings are ground-glass opacities along with septal thickening (Crazy Paving), consolidations, and less commonly air bronchograms. COVID-19 is a viral infection caused by SARS COV2 primarily affecting the lungs and causing atypical viral pneumonia. The clinical picture of the disease varies from a milder form of fever, dry cough with or without expectoration, to severe disease-causing respiratory distress, pneumonia, acute respiratory distress syndrome (ARDS), and even death. Radiologically, the findings of COVID-19 are similar to PAP. So, PAP mimics the COVID-19, posing a differential challenge, though our patient was a known case of PAP. Therefore, for proper management of the disease, it is important to differentiate it from other pathologies. In this case report, we describe a patient who was a known case of autoimmune pulmonary alveolar proteinosis. She presented with acute exacerbation in the emergency department and tested positive for COVID-19. We followed a systematic approach consisting of clinical, laboratory, radiologic parameters to differentiate the cause of this exacerbation.

Safety and efficacy of low-dose selective spinal anesthesia with bupivacaine and fentanyl as compared to intravenous sedation and port-site infiltration for outpatient laparoscopic tubal ligation: A randomized controlled trial

Anesthesia: Essays and Researches, 2021

Selective spinal anesthesia has been safely applied for short-duration outpatient gynecological l... more Selective spinal anesthesia has been safely applied for short-duration outpatient gynecological laparoscopic procedure. However, this anesthesia technique is often inadequate and not tolerated by awake patients due to pneumoperitoneum and visceral manipulation. We aimed to conduct a study to compare spinal anesthesia with bupivacaine, fentanyl, and i.v. sedation with i.v. sedation and laparoscopic port-site infiltration with local anaesthetic in outpatient laparoscopic tubal ligation procedures. 100 female patients posted for elective surgeries were recruited for a prospective single blind randomised control trial in a tertiary care center in two groups. In Group S, patients receive intrathecal 3 mg hyperbaric bupivacaine 0.5% plus 20 microgram fentanyl along with intravenous (i.v.) fentanyl at 1μg.kg-1.h-1 and in Group C i.v. fentanyl at 1μg.kg-1.h-1 along with laparoscopic port site infiltration with 0.5% bupivacaine. Postoperatively, overall patient satisfaction, visual analog score (VAS) score, duration of motor blockade, sensory blockade, and time to attain discharge criteria and any adverse. Continuous variables between the groups were compared by the independent t-test and Wilcoxon rank sum. Chi-square and Fisher exact test used for the categorical value. Overall VAS was significantly lower and patient satisfaction was higher in Group S than Group C. Time to oral intake was significantly prolonged in Group C 126.33 (±29.54) compared to group S 110.81 (±29.54). The requirement of total rescue analgesia (fentanyl) was significantly higher in Group C 2.0 (±0.6) μg.kg-1 compared to group S 0.79 (±0.53) μg.kg-1. Incidence of postoperative nausea vomiting (PONV) was significantly greater in Group C while incidence of pruritus was significantly greater in Group S. Low-dose intrathecal anesthesia with 3 mg bupivacaine and 20 μg fentanyl provided better analgesia, patient satisfaction and with less opioids consumption.

Journal of Laboratory Physicians, 2022

Rapid antigen testing for coronavirus disease 2019 (COVID-19) available at present provides immed... more Rapid antigen testing for coronavirus disease 2019 (COVID-19) available at present provides immediate results at low cost with less expertise and without any need of sophisticated infrastructure. Most of these test kits available are for nasopharyngeal samples. This is a novel study to detect the presence of COVID antigen in samples other than throat and oropharyngeal. Various samples received from patients admitted in the COVID-19 dedicated center were tested for the presence of antigen. Same procedure was followed as done for the nasopharyngeal sample. A total of 150 samples were tested, which included ascitic fluid, pleural fluid, drain fluid, bile, bronchoalveolar lavage, cerebrospinal fluid, endotracheal tube aspirate, sputum, tissue, and urine. Out of 150, 11 (7.33%) were positive and 138 (92.66%) were negative for the antigen test. The COVID-19 antigen test kit, though designed for nasopharyngeal samples, was able to detect the presence of antigen in other clinical samples.

Tracheostomy in Patients with Coronavirus Disease 2019: An Overview

Turkish Journal of Anaesthesiology and Reanimation, 2020

As the coronavirus disease 2019 (COVID-19) pandemic is gripping the entire world, many patients a... more As the coronavirus disease 2019 (COVID-19) pandemic is gripping the entire world, many patients are mainly presenting with respiratory problems and subsequently require intubation and mechanical ventilation in severe cases. The need to perform tracheostomy may arise, and the intensivist, anaesthetist, and other surgical specialties may be asked to perform a tracheostomy in known COVID-19 or suspected patients. Surgeons should be prepared for this eventuality while performing the procedures, taking all the measures to keep themselves and their team members safe from the undue risk of infection and exposure. This is a brief review of all the evidence present, till now, for those who will be performing tracheostomy in such patients. [ABSTRACT FROM AUTHOR] Copyright of Turkish Journal of Anesthesia & Reanimation is the property of Turkish Society of Anaesthesiology & Reanimation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Journal of Anaesthesiology Clinical Pharmacology, 2020

13. Interim considerations for infection prevention and control of coronavirus disease 2019 (COVI... more 13. Interim considerations for infection prevention and control of coronavirus disease 2019 (COVID-19) in inpatient obstetric healthcare settings 2020. Available from: https:// www.cdc.gov/coronavirus/2019-ncov/hcp/inpatientobstetric-healthcare-guidance.html. [Last accessed on 2020 Jun 20]. 14. Association of Anaesthetists. Management of severe local anaesthetic toxicity.

Indian Journal of Anaesthesia, 2020

The corona virus disease 2019 (COVID-19) pandemic sweeping across the world has severely strained... more The corona virus disease 2019 (COVID-19) pandemic sweeping across the world has severely strained health care resources (equipment and personnel) forcing us to rethink strategies to provide obstetric care while judiciously using resources. We describe the anaesthetic management of a mildly symptomatic, COVID-19 positive, 28-year-old second gravida with term pregnancy who was taken up for an elective caesarean section under subarachnoid block in a standalone maternity facility. Challenges encountered and modifications of standard procedures so as to optimize patient care and minimize exposure of health care professionals are also discussed.

Saudi Journal of Anaesthesia, 2019

Background: Postspinal anesthesia hypotension (PSH) in pregnant women is common and may lead to p... more Background: Postspinal anesthesia hypotension (PSH) in pregnant women is common and may lead to poor maternal and fetal outcome. Fluid loading in pregnant women before spinal anesthesia to prevent hypotension is of limited ability. We hypothesized that those women who are hypovolemic before spinal anesthesia may be at risk of PSH and inferior vena cava collapsibility index (IVCCI) will be able to identify hypovolemic parturients. Methods: In this prospective observational study, n = 45 women undergoing elective lower segment cesarean section with singleton pregnancy were recruited and IVCCI in left lateral tilt (with wedge) and supine position (without wedge) were noted by M-mode ultrasound (USG) before spinal anesthesia. After spinal anesthesia, changes in blood pressure were noted till 15 min after spinal anesthesia. Results: USG measurements were obtained in 40 patients and 23 of 40 patients (57.5%) had at least one episode of hypotension. Area under the ROC curve of IVCCI with wedge to predict PSH was 0.46 (95% CI 0.27, 0.64) and best cut-of value was 25.64 with a sensitivity and specificity of 60.9% and 35.5%, respectively. Area under the ROC curve of IVCCI without wedge to predict PSH was 0.38 (95% CI 0.19, 0.56) and best cut-of value was 20.4 with a sensitivity and specificity of 69.6% and 23.5%, respectively. Conclusion: We conclude that IVCCI is not a predictor of PSH in pregnant women undergoing elective cesarean section.

Awake videolaryngoscopy-guided intubation in a patient with laryngocoele

Airway, 2019

Laryngocoele is a rare, benign laryngeal disease causing a variety of symptoms. However, this con... more Laryngocoele is a rare, benign laryngeal disease causing a variety of symptoms. However, this condition can lead to upper airway obstruction, thus posing problems in airway management and ventilation. Therefore, prior planning of anaesthetic and airway management of such patients is desirable, wherein awake intubation techniques are safer methods of securing a definite airway. Awake videolaryngoscopy-guided intubation can be safely used as an alternative to awake fibreoptic bronchoscopy-guided intubation.

Indian Journal of Clinical Anaesthesia, 2019

Introduction: Hyperbaric preparation of local anaesthetics have been used in subarachnoid block t... more Introduction: Hyperbaric preparation of local anaesthetics have been used in subarachnoid block till now. Levobupivacaine and Ropivacaine, newly introduced S-enantiomer related to bupivacaine, have low cardio-neurotoxicity profile. In this study isobaric form of Levobupivacaine and Ropivacaine with Fentanyl were evaluated in terms of clinical efficacy as well as block characteristics. Materials and Methods: In this prospective, single blind study, sixty patients of ASA grade I or II, 20-65yrs of age, of either sex, posted for lower abdominal or lower extremity surgery, were randomly administered either 3 ml Levobupivacaine (0.5%) or Ropivacaine (0.75%) with Fentanyl (25µg). Intra and postoperative block characteristic, hemodynamic parameters as well as side effects were recorded. Results: Time to reach T10 sensory level and bromage 1 was earlier in group LF compared to group RF (p value =0.001). Peak sensory level was T6-T8 in group LF and T8-T10 in group RF. Significantly longer duration of sensory and motor block was produced in group LF (271.5 ± 5.06 and 252.16 ± 4.69 min) compared to group RF (228 ± 4.16 and 195.33 ± 3.54 min). The time to first rescue analgesia was also significantly prolonged in group LF (292.83 ± 5.28 min) compared to group RF (258 ± 4.32 min) (p value =0.001). Conclusion: Equipotent doses of isobaric Levobupivacaine and Ropivacaine with Fentanyl (25µg) offered satisfactory anaesthesia with minimal haemodynamic variability. Levobupivacaine produced rapid onset and prolonged anaesthesia while Ropivacaine provided rapid recovery of sensory and motor block and early mobility, suitable for day care surgery.

Anaesthesiology Intensive Therapy, 2022

Barotrauma has long been known as a complication of mechanical ventilation in the intensive care ... more Barotrauma has long been known as a complication of mechanical ventilation in the intensive care unit (ICU), and has been associated with prolonged hospitalization, increased morbidity and poorer outcomes [1]. However, this complication has gained renewed prominence during the coronavirus 2019 (COVID-19) pandemic, due to reports of considerably increased incidence amongst COVID-19 patients [2-4]. Manifestations of barotrauma have been noted even in non-mechanically ventilated patients-patients with mild or moderate disease, who are usually considered at lower risk for barotrauma [3]. The incidence of barotrauma and associated manifestations such as pneumothorax can range from 1% of hospitalised COVID-19 patients to 15% in mechanically ventilated COVID-19 pa

Indian Journal of Pediatrics

Children with cystic fibrosis (CF) constitute a high-risk group for COVID-19 with underlying chro... more Children with cystic fibrosis (CF) constitute a high-risk group for COVID-19 with underlying chronic lung disease. COVID-19 severity varying from mild infection to need of intensive care has been described in children with CF. Two children with significant underlying pulmonary morbidity are described here, who developed severe disease following SARS-CoV-2 infection. Case 1 (a 9-y-old boy) had pneumonia with respiratory failure requiring noninvasive ventilation support. He had delayed clearance of SARS-CoV-2, with recurrence of symptomatic disease with short asymptomatic period in between. He was also diagnosed with CF-related diabetes and allergic bronchopulmonary aspergillosis during the second episode. Case 2 (an 18-mo-old boy) had two episodes of SARS-CoV-2-related severe lower respiratory infection within a period of 2 mo, requiring high-flow nasal oxygen support. Both children had 3 rd pulmonary exacerbation but SARS-CoV-2 was not detected in respiratory secretions. To conclude, children with CF with underlying pulmonary morbidity, can develop severe COVID-19 and prolonged SARS-CoV-2 shedding.