• Title/Summary/Keyword: blind patient

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Blind nasal intubation as an alternative to difficult intubation approaches

  • Yoo, Hwanhee;Choi, Jae Moon;Jo, Jun-young;Lee, Sukyung;Jeong, Sung-Moon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.3
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    • pp.181-184
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    • 2015
  • Airway difficulties are a major concern for anesthesiologists. Even though fiberoptic intubation is the generally accepted method for management of difficult airways, it is not without disadvantages-requires patient cooperation, and cannot be performed on soiled airway or upper airways with pre-existing narrowing pathology. Additionally, fiberoptic bronchoscopy is not available at every medical institution. In this case, we encountered difficult airway management in a 71-year-old man with a high Mallampati grade and a thick neck who had undergone urologic surgery. Several attempts, including a bronchoscope-guided intubation, were unsuccessful. Finally, blind nasal intubation was successful while the patient's neck was flexed and the tracheal cartilage was gently pressed down. We suggest that blind nasal intubation is a helpful alternative in difficult airway management and it can be a lifesaving technique in emergencies. Additionally, its simplicity makes it a less expensive option when advanced airway technology (fiberoptic bronchoscopy) is unavailable.

A New Robust Blind Crypto-Watermarking Method for Medical Images Security

  • Mohamed Boussif;Oussema Boufares;Aloui Noureddine;Adnene Cherif
    • International Journal of Computer Science & Network Security
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    • v.24 no.3
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    • pp.93-100
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    • 2024
  • In this paper, we propose a novel robust blind crypto-watermarking method for medical images security based on hiding of DICOM patient information (patient name, age...) in the medical imaging. The DICOM patient information is encrypted using the AES standard algorithm before its insertion in the medical image. The cover image is divided in blocks of 8x8, in each we insert 1-bit of the encrypted watermark in the hybrid transform domain by applying respectively the 2D-LWT (Lifting wavelet transforms), the 2D-DCT (discrete cosine transforms), and the SVD (singular value decomposition). The scheme is tested by applying various attacks such as noise, filtering and compression. Experimental results show that no visible difference between the watermarked images and the original images and the test against attack shows the good robustness of the proposed algorithm.

Reduction of Nasal Bone Fracture using Ultrasound Imaging during Surgery

  • Hwang, So-Min;Pan, Hao-Ching;Kim, Hong-Il;Kim, Hyung-Do;Hwang, Min-Kyu;Kim, Min-Wook;Lee, Jong-Seo
    • Archives of Craniofacial Surgery
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    • v.17 no.1
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    • pp.14-19
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    • 2016
  • Background: Most nasal bone fractures are corrected using non-invasive methods. Often, patients are dissatisfied with surgical outcomes following such closed approach. In this study, we compare surgical outcomes following blind closed reduction to that of ultrasound-guided reduction. Methods: A single-institutional prospective study was performed for all nasal fracture patients (n=28) presenting between May 2013 and November 2013. Upon research consent, patients were randomly assigned to either the control group (n=14, blind reduction) or the experimental group (n=14, ultrasound-guided reduction). Surgical outcomes were evaluated using preoperative and 3-month postoperative X-ray images by two independent surgeons. Patient satisfaction was evaluated using a questionnaire survey. Results: The experimental group consisted of 4 patients with Plane I fracture and 10 patients with Plane II fracture. The control group consisted of 3 patients with Plane I fracture and 11 patients with Plane II fracture. The mean surgical outcomes score and the mean patient dissatisfaction score were found not to differ between the experimental and the control group in Plane I fracture (p=0.755, 0.578, respectively). In a subgroup analysis consisting of Plane II fractures only, surgeons graded outcomes for ultrasound-guided reduction higher than that for the control group (p=0.007). Likewise, among the Plane II fracture patients, those who underwent ultrasound-guided reduction were less dissatisfied than those who underwent blind reduction (p=0.043). Conclusion: Our study result suggests that ultrasound-guided closed reduction is superior to blind closed reduction in those patients with Plane II nasal fractures.

A Double-blind Comparison of 0.125% Ropivacaine with Fentanyl and 0.125% Bupivacine with Fentanyl for Labor Analgesia Using Patient-Controlled Epidural Infusion (지속적 통증조절기를 이용한 경막외강으로 Fentanyl을 첨가한 0.125% Ropivacaine과 0.125% Bupivacaine 주입시 분만통 조절에 대한 효과)

  • Choi, Jeong-Hwan;Lee, Hae-Jin;Sung, Choon-Ho
    • The Korean Journal of Pain
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    • v.13 no.1
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    • pp.67-73
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    • 2000
  • Background: This study intends to evaluate the benefits of the administation of continuous infusion and demand doses of 0.125% ropivacaine compared with 0.125% bupivacaine after addition of fentanyl using patient controlled epidural analgesia (PCEA) for pain control during labor. Methods: Thirty-nine American Society of Anesthesiologists physical status 1 or 2 parturients were randomized by double blind design to receive either 0.125% bupivacaine with fentanyl 1 ug/ml or equivalent concentration of ropivacaine/fentanyl using PCEA; with 6~8 ml/hr basal rate, 3 ml bolus, 5 min lockout, 30 ml/hr dose limit. We assessed analgesia, the amount of study solution used in PCEA, sensory levels, motor block (0~3 scales), side effects and patient satisfaction. A postpartum questionnaire was carried out afterward. Results: There were no differences in visual analogue scores (VAS) for pain, hourly study solution use, sensory levels, side effects and patient satisfaction between groups. However, patients administered ropivacaine/fentanyl had significantly less demand, less administered in PCEA, less numbness and restriction of movement compared with patients in the bupivacaine/fentanyl group. Conclusions: Ropivacaine 0.125% with fentanyl, when administerd epidurally by PCEA for labor analgesia, was equally efficious as bupivaciane 0.125% with fentanyl, having with minimal numbness and restriction of motion.

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The Effects of Acupuncture Treatment on Hwa-byung patient's Insomnia: Patient-assessor blind, Randomized, Placebo-controlled Clinical trial (화병환자의 불면증상에 대한 침치료 유효성 평가연구: 환자-평가자 눈가림, 무작위배정, 일반대조군 임상시험)

  • Lee, Go-Eun;Kim, Nam-Kwon;Kim, Hang-Yi;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.23 no.1
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    • pp.31-48
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    • 2012
  • Objectives: The purpose of this research is to examine the effects of acupuncture treatment on Hwa-byung patient's insomnia. Methods: The study was performed through a patient-assessor blind, randomized, placebo-controlled trial in which the volunteers, data collectors and analysts were unaware of individuals who were receiving the treatment. A total of thirty-seven volunteers were divided into 2 groups. 18 subjects were placed into a trial group and 19 subjects into a control group by a randomization table. The trial group was treated on bilateral Shigu, Ahnmyun, B62 (Shinmaek), and K6 (Chohae), while the control group was not given any other treatment. The ISI(Insomnia Severity Scale) was measured as the 1st evaluative instrument, and then a comparative analysis was conducted by comparing the results with those measured by a Likert scale for major symptoms of Hwa-byung, PSQI, Hwa-byung scale, BDI, STAI, and STAXI. Results: In the ISI, PSQI, and the Likert scale regarding major symptoms of Hwa-byung, Hwa-byung scale, BDI, and STAI, more significant decreases were found in those concerning the trial group compared to those of the control group from a statistical perspective. However, in the STAXI, regarding the trial group, there was no significant decrease compared to the control group. Conclusions: The results suggest that acupuncture treatment is effective in the treatment regarding Hwa-byung patients who suffer from insomnia.

Ultrasound guidance versus the blind method for intrauterine catheter insemination: A randomized controlled trial

  • Mubarak, Sarah;Yusoff, Noor Haliza;Adnan, Tassha Hilda
    • Clinical and Experimental Reproductive Medicine
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    • v.46 no.2
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    • pp.87-94
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    • 2019
  • Objective: The primary objective of this study was to compare clinical pregnancy rates in intrauterine insemination (IUI) treatment cycles with transabdominal ultrasound guidance during intrauterine catheter insemination (US-IUI) versus the "blind method" IUI without ultrasound guidance (BM-IUI). The secondary objective was to compare whether US-IUI had better patient tolerability and whether US-IUI made the insemination procedure easier for the clinician to perform compared to BM-IUI. Methods: This was a randomized controlled trial done at the Reproductive Medicine Unit of General Hospital Kuala Lumpur, Malaysia. We included women aged between 25 and 40 years who underwent an IUI treatment cycle with follicle-stimulating hormone injections for controlled ovarian stimulation. Results: A total of 130 patients were recruited for our study. The US-IUI group had 70 patients and the BM-IUI group had 60 patients. The clinical pregnancy rate was 10% in both groups (p> 0.995) and there were no significant difference between the groups for patient tolerability assessed by scores on a pain visual analog scale (p= 0.175) or level of difficulty for the clinician (p> 0.995). The multivariate analysis further showed no significant increase in the clinical pregnancy rate (adjusted odds ratio, 1.07; 95% confidence interval, 0.85-1.34; p= 0.558) in the US-IUI group compared to the BM-IUI group even after adjusting for potential covariates. Conclusion: The conventional blind method for intrauterine catheter insemination is recommended for patients undergoing IUI treatment. The use of ultrasound during the insemination procedure increased the need for trained personnel to perform ultrasonography and increased the cost, but added no extra benefits for patients or clinicians.

Comparison of Patient Controlled Epidural Analgesia Alone and Patient Controlled Epidural Analgesia with Continuous Infusion (단독 경막외 통증자가조절법과 지속주입을 병용한 경막외 통증자가조절법의 비교)

  • Kim, Dong-Hee;Lee, Tae-Soo
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.368-373
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    • 1996
  • Background: The purpose of this study was to determine whether there is any advantage for a continuous background infusion during patient controlled epidural analgesia(PCEA) for postoperative pain control. Methods: 60 patients scheduled for elective cesarean section under epidural anesthesia were assigned randomly in a double-blind fashion to receive fentanyl and bupivacaine by PCEA with or without background infusion for 48 hours postoperatively. Results: Total amount of fentanyl and bupivacaine consumption and degree of sedation were not significantly different between the two groups. Visual analogue scale(VAS) pain scores at 24, 36, and 48h and sleep disturbance were significantly lower in background infusion group. Conclusion: Administration of fentanyl with bupivacaine by continuous background infusion is appropriate for PCEA for postcesarean section pain control.

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MRI Findings of Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA syndrome) with a Blind Megaureter: Case Report

  • Cho, Yun Hee;Sung, Deuk Jae;Han, Na Yeon;Park, Beom Jin;Kim, Min Ju;Sim, Ki Choon;Cho, Sung Bum
    • Investigative Magnetic Resonance Imaging
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    • v.19 no.3
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    • pp.196-199
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    • 2015
  • Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is an uncommon congenital abnormality of the female urogenital tract characterized by the triad of uterine didelphys, obstructed hemivagina, and ipsilateral renal agenesis. A 13-year-old female presented with acute lower abdominal pain. Magnetic resonance imaging (MRI) revealed uterine didelphys, hematometrocolpos, obstructed hemivagina, and right ipsilateral agenesis, consistent with OHVIRA syndrome. Also, a well-defined mass with fluid signal intensity, mimicking adnexal neoplasm was seen in the right lower pelvic cavity adjacent to the posterior wall of the bladder. Vaginal septotomy and drainage of hematometrocolpos were done initially, but unilateral hysterectomy was later performed to relieve the patient's symptoms. The cystic mass in the right lower pelvic cavity was also excised and confirmed as a blind megaureter.

Blind Intubation Using Fiberoptic Bronchoscope in Epistaxis (비출혈 환자에서 굴곡성 기관지를 이용한 맹목적 기관내 삽관)

  • Lee, Seung-Hyun;Yoon, Ji-Young;Kim, Cheul-Hong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.2
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    • pp.121-123
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    • 2012
  • Nasotracheal intubation is an essential procedure during general anesthesia for dental treatment. Fiberoptic intubation is best accomplished by those who perform it as part of their daily practice. But nasal approach of fiberoptic intubation has some complications such as epistaxis and laryngeal injury. Especially, epistaxis is common and it make fiberoptic intubation because of limited view. When the epistaxis obstruct the field of vision we have to withdraw the fiberoptic bronchoscope and consider the other method for securing the airway. We succeeded in securing the airway of patient who had epistaxis during the fiberoptic nasotracheal intubation without withdrawing the fiberoptic bronchoscope. We used blind intubation guided by light source placed the tip of fiberoptic bronchscope applied to lightwand intubation.