Airway Papers & Publications

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

India is a country of immense diversity. It is home to people of many different racial, languages, ethnic, religious, and national backgrounds. Groups of people in India differ from each other not only in physical or demographic characteristics but also in distinctive patterns of behavior and these patterns are determined by social and cultural factors like language, region, religion, and caste. Apart from behaviour, economic development, level of education and political culture of the people in various social segments differ from region to region. More you can say that economy and cultures have been enriched by the contributions of migrants from round the globe. In an increasingly globalised world, migratory movements is continuously shaping the countries all over the world. Some countries like India and Ireland, which set the example of economic development and social integration, have the positive impact of the migration by globalisation and some countries like USA, which recently witness racism, xenophobia and discrimination have the negative impact on the migrants. It does not mean India do not face fragmentation and USA do not have cohesion. USA have many stories which show successful integration process, that facilitated the lives of immigrant communities, but being a developed country it still suffers from cultural alienation. In these countries, borders are built within borders to create cultural divides that do not allow people to integrate. Recently, this problem has become more prominent due to the rise of terrorism, clash of cultures in the world, leading to the glorification of stereotypes. People are becoming less accepting towards anyone who does not belong to their region. Migration does not stop after people move from one place to another place. The main question start after that ‘now what’ they will do. That is why this topic needs to be discussed thoroughly in order to find better solutions. This paper will begin with an analysis of different approaches to Migration, discuss the target groups for integration policies, provide indicators of the current situation of migrants and proceed to an analysis of integration tools: legislation, social policies and participatory processes. It will focus not only on the impact of migration but also on social integration, mix culture like indo-western culture in a comparative basis.

Ekta Meena

In this paper, investigations are made to analyze the human body temperature during wound healing process due to surgery. Wound is considered after the skin graft. Skin graft is a technique used in plastic surgery. Skin is the first line of defense between the human and environment, it is very susceptible to damage. Internal body or core temperature (Tb) is one of the clinical vital signs along with pulse and respiratory rates. Any disturbance in body temperature will drive complexities in wound healing process. These studies are important in the mechanism of establishing the limits of thermal regulation of human body during the healing process in different situations and conditions. The Finite element method is used to analyze tissues temperature for normal tissues (donor site) and abnormal tissues (tissues after surgery). Appropriate boundary conditions have been framed. Numerical results are obtained using Crank Nicolson Method.

Manisha Jain

Physically unclonable function (PUF) is a hardware security module preferred for hardware feature based random number and secret key generation. Security of a cryptographic system relies on the quality of the challenge-response pair, it is necessary that the key generation mechanism must unpredictable and its response should constant under different operating condition. Metastable state in CMOS latch is undesirable since it response becomes unpredictable, this feature used in this work to generate a unique response. A feedback mechanism is developed which forces the latch into the metastable region; after metastable state, latch settle to high or state depends on circuit internal condition and noise which cannot be predicted. Obtained inter hamming variation for 8 PUF is 51% and average intra hamming distance is 99.76% with supply voltage variation and 96.22% with temperature variation.

Abhishek Kumar

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

One of the unique features of Indian society is prevalence of caste system which was originated thousands of years back to demarcate the people engaged in different occupation or jobs. Initially it was not much rigid but gradually people belonging to upper castes for their own selfish means to maintain their monopoly made this arrangement hereditary and started treating people of lower castes disgracefully. For preservation of this system, people started controlling their women to prevent inter-caste marriages and the concept of endogamy came up. This robbed away many types of freedom from women. For women belonging to lower castes, this situation is worse as they are doubly subjugated on the basis on caste as well as gender. Men belonging to their own caste treat them as secondary beings. This paper throws light on this intersection. How intersection of these two kinds of inequalities place them at the lowest position in Indian society. Dr. B.R. Ambedkar rises as their leader who all his life worked for empowerment of downtrodden section of society. He argues that education is the primary tool for evading these differences among people. He further emphasizes to adopt the concept of exogamy to break the backbone of Indian caste system and to immediately leave a religion or culture which legitimizes such system of inequality among people of the same land.

Swati sharma

The wind tunnel experimental study has been carried out on a double delta wing of different geometrical configurations such as 80°/45°, 75°/45° and 70°/45° sweep angles given as Model I, Model II and Model III with various freestream velocities from 10 to 40 m/s with a step of 10 m/s in Hindustan Institute of Technology and Science, Chennai, Low Speed Wind tunnel (HITSLSWT). The experiment is conducted for the measurement of lift and drag forces using single component force balance. The investigation was done to look into the effects of changing the double delta wing's leading edge sweep angles. Three differentmodels have been tested at various angles of attack ranging from0° to +16° and 0° to −16° with 4° and four different freestream velocities based on the delta wing’s chord. It is observed that the influence of variation of leading edge sweep angles affects the performance of aerodynamic characteristics of themodel. The increase in angle in attack with increased velocity gives better aerodynamic performance. This paper provides good insight into the aerodynamic force measurement of double delta wing and the low-speed performance of the models.

Boopathy Govindarajan

The blunted nose cone with and without a sharp aerospike and an aerodisk of various diameters and lengths are investigated numerically in detail in the current study at a hypersonic Mach number of 10. The aerodisk diameter is described as d/D ratios such as 0.2, 0.4 and 0.6, and the length of the aerospike is represented as the L/D ratio of 1, 1.5 and 2. The main objective of the research is to examine the aerodynamic properties of blunt noses with and without aerodisks and aerospikes, as well as the influence of shock production over the model. The design of blunted nose cones with aerodisk was made up using CATIA and numerical investigation was performed on the ANSYS Fluent. The turbulence model of SST k-omega was considered for study. The current study revealed that shock patterns drastically varied nearer to the nose cone model at L/D ratio 2 and variation of drag reduction occurred due to the increase in d/D ratio and aerospike and also flow pattern over the model was clearly investigated.

Boopathy Govindarajan

This case report presents a rare instance of solitary endobronchial plasmacytoma in a 58-year-old male, who had progressively worsening shortness of breath and a productive cough. The patient, who had a smoking history, was found to have a large, hypervascular mass completely obstructing the right main bronchus, confirmed as a plasma cell tumor via endoscopic biopsy. Further diagnostic imaging, including positron emission tomography-computed tomography (PET-CT) and chest CT, revealed a mass measuring 1.7 cm with abnormal fluorodeoxyglucose (FDG) uptake. The bone marrow biopsy ruled out multiple myeloma. The patient underwent challenging endoscopic debulking of the tumor, although margins were not well defined due to its size. Post-operatively, the patient showed significant symptomatic improvement and was discharged home on post-operative day 4. Two months after the procedure, follow-up with a chest CT scan and bronchoscopy showed no evidence of residual tumor or local recurrence, and the patient reported significant respiratory improvement. The literature review revealed that extramedullary plasmacytoma (EMP) is uncommon and often occurs in the upper aerodigestive tract. The diagnostic workup generally involves histopathological analysis, bronchoscopy, and imaging studies. Treatment is tailored to the patient’s condition and the characteristics of the tumor. This case underscores the need for a high index of suspicion and comprehensive diagnostic evaluation of patients presenting with obstructive bronchial mass. Furthermore, it highlights the importance of considering endobronchial plasmacytoma in the differential diagnosis of obstructive bronchial masses and the value of early intervention in achieving favorable outcomes. Regular follow-up is crucial to monitor recurrence and ensure ongoing patient well-being.

Mohamad Banat

Background and Aim: Second and third-generation supraglottic airway devices (SADs) are increasingly used in laparoscopic surgeries due to their improved oropharyngeal seal and gastric drainage. This study evaluated and compared the clinical efficacy of the Ambu AuraGain (AAU) and the i-gel in patients undergoing laparoscopic cholecystectomy. Materials and Methods: In this prospective, randomized comparative study, 80 adult patients (ASA I and II) were randomly assigned to two groups (n=40 each): Group A (Ambu AuraGain) and Group G (i-gel). The primary objective was to compare oropharyngeal leak pressure (OLP). Secondary objectives included insertion time, ease of insertion, success rate, fiberoptic view of the glottis, and postoperative complications. OLP and peak airway pressure (PAP) were measured at various intervals, including during carboperitoneum. Results: The mean OLP was significantly higher in Group A than in Group G, both after insertion (32.9 ± 3.45 vs. 26.53 ± 1.61 cm H2O; p<0.001) and after deflation of carboperitoneum (34.15 ±2.9 vs. 28.2 ±1.71 cm H2O; p<0.001). The margin of safety (OLP–PAP) was significantly higher in the AAU group at all times (p<0.001). However, the i-gel was significantly faster to insert (14.8 ±2.94 vs. 22 ± 3.74 seconds; p<0.001) and easier to place (100% easy vs. 37.5% easy; p<0.001). Fiberoptic alignment was significantly better in the i-gel group, with 70% achieving a Grade 4 view compared to 29% in the AAU group (p<0.001). Postoperative complications were low and comparable between groups. Conclusion: Ambu AuraGain provides a superior oropharyngeal seal and a higher safety margin against leaks during laparoscopic surgery compared to i-gel. Conversely, i-gel is superior in terms of ease of insertion, speed, and anatomical alignment with the glottis, making it a better conduit for fiberoptic-guided intubation. Keywords: Ambu AuraGain, i-gel, Laparoscopic cholecystectomy, Oropharyngeal leak pressure, Supraglottic Airway device.

Journal of Scientific Innovations in Anesthesiology

Background: In dental practice, local anesthesia plays a very important role as it makes the patient more comfortable during his or her procedures. Nevertheless, difficulty in getting adequate anesthesia is still common because of several reasons such as the differences in anatomy, psychological considerations as well as technique related problems. The research paper will identify the knowledge, attitudes and practices (KAP) of dental professionals in relation to local anesthetic use and subsequent improvement of pain management in dentistry by establishing areas of weaknesses and suggesting means to address them. Methods: A cross-sectional survey of 150 dental practitioners comprising general dentists, dental surgeons as well as specialists was carried out to determine knowledge, attitudes and practices of dental practitioners with regard to local anesthesia. The questionnaire was made to gauge the knowledge of the respondents with regard to anesthetic agent, effects of psychological factors, and how the respondents approach the issue of anesthesia failure in their practice. Analysis was done based on descriptive statistics to give an insight into the common practices and areas of concern. Results: The survey showed that 85 percent of respondents used Lidocaine as their choice of anesthetic, 60 percent of them reported anatomical differences as the major factor of anesthesia efficacy and 85 percent of the respondents reported the critical role of patient anxiety. On the issue of confidence in administering local anesthesia, 40 percent had high confidence and 50 percent had some incidences of poor anesthesia. In case of the failure in anesthesia, 60 percent of practitioners chose to administer higher dosage instead of sending patients to experts. Conclusion: Although the majority of dental practitioners have a good grasp of the knowledge and confidence in the administration of the local anesthesia, there are some areas where improvements can be made, especially when addressing the psychological factors and communicating with patients. Patient-centered care methods and additional training are critical to maximising the efficacy of anesthesia. Keywords: Local anesthesia, Dental practitioners, Knowledge, Patient anxiety, Anesthesia failure.

Journal of Scientific Innovations in Anesthesiology

Vallecular cysts, although infrequent in adults, pose a challenge for anesthesiologists in view of the risk of airway obstruction at anesthesia induction or aspiration in case of cyst rupture. The present case is of a 35-year-old male patient who was scheduled for excision of a vallecular cyst. An awake technique was initially decided for nasotracheal intubation using a flexible videolaryngoscope, AmbuscopeTM, after complete topicalization of the airway with local anesthesia. However, anticipating the need for a tracheostomy, the surgical team was prepared, and this was timely chosen as the only viable option following failure to visualize the glottis despite negotiating every possible way around the cyst. This case highlights the successful management of a large vallecular cyst in an adult patient, where failed awake nasotracheal intubation despite optimal preparation necessitated an early, planned tracheostomy. This reiterates the fact that the surgical airway may not be always chosen as the last resort in crisis but also as a timely intervention to prevent an airway catastrophe.

Journal of Scientific Innovations in Anesthesiology