Annals of African Medicine最新文献

{"title":"Blood Glucose Response after Betamethasone Injection in Pregnant Women without Diabetes.","authors":"Pankaj Prakash Salvi, Vidya Ajit Gaikwad, Rushikesh Anil Phutane","doi":"10.4103/aam.aam_372_25","DOIUrl":"10.4103/aam.aam_372_25","url":null,"abstract":"<p><strong>Background: </strong>Betamethasone is routinely administered in preterm pregnancies to accelerate fetal lung maturity, yet its glycemic impact on nondiabetic pregnant women remains underexplored.</p><p><strong>Objective: </strong>This study aimed to evaluate the effect of betamethasone on maternal glucose levels and hormonal profiles in pregnant women without diabetes and assess the need for monitoring and intervention.</p><p><strong>Materials and methods: </strong>A prospective observational study was conducted on 80 normoglycemic pregnant women between 24 and 34 weeks of gestation. Each participant underwent an Oral glucose tolerance test and hormonal profiling before and after receiving the first intramuscular dose of injection betamethasone 12 mg. The second dose of injection Betamethasone 12 mg was given 24 h later.</p><p><strong>Results: </strong>Significant elevations in fasting, 1-h, and 2-h blood glucose levels were observed postbetamethasone ( P < 0.001), along with increased insulin, C-peptide, and cortisol levels, indicating a steroid-induced metabolic shift. Hyperglycemia peaked within 12-24 h. Elevated body mass index and borderline glycated hemoglobin were associated with greater glucose excursions.</p><p><strong>Conclusion: </strong>Even a single course of betamethasone can induce clinically significant hyperglycemia in nondiabetic pregnant women. Routine poststeroid glucose monitoring is essential to minimize maternal and neonatal risks while preserving the established benefits of antenatal corticosteroids.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1504-1509"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145802913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vertigo-unsolved Mystery (Meniere's Disease) Care Redefined: Insights from a Tertiary Care Center.","authors":"Arti Rajpoot, Rajat Jain, Sunil Kumar, Abhishek Bahadur Singh, Veerendra Verma, Manish Chandra, Anupam Mishra","doi":"10.4103/aam.aam_340_25","DOIUrl":"10.4103/aam.aam_340_25","url":null,"abstract":"<p><strong>Background: </strong>Meniere's disease remains a poorly understood inner ear disorder since its first description by Prosper Meniere in the early 1800s. Characterized by episodic vertigo, fluctuating hearing loss, and tinnitus, it continues to challenge clinicians due to its unpredictable course and variable treatment response. Lifestyle modification alone often fails to adequately control vertigo episodes.</p><p><strong>Aim and objectives: </strong>To assess the effectiveness of oral pharmacotherapy in controlling vertigo and stabilizing hearing in patients with Meniere's disease, and to develop a practical, non-invasive treatment protocol suitable for routine clinical use.</p><p><strong>Materials and methods: </strong>Patients diagnosed with Meniere's disease as per 1995 AAO-HNS criteria were managed with standard lifestyle advice followed by oral pharmacotherapy, including an antihistaminic agent (betahistine) and a combination of diuretics (furosemide and spironolactone). Treatment response was evaluated based on vertigo control, reduction in episode frequency, and stabilization of audiometric thresholds. Surgical options were considered only for patients with persistent, disabling vertigo despite maximal medical therapy.</p><p><strong>Results: </strong>Lifestyle measures alone did not provide adequate vertigo control. In contrast, combined oral pharmacotherapy resulted in marked improvement, with significant reduction in vertigo frequency and satisfactory stabilization of hearing levels. Only a small proportion of patients required evaluation for surgical intervention.</p><p><strong>Conclusion: </strong>A regimen combining betahistine with diuretics offers a reliable, non-invasive, and effective approach to managing Meniere's disease. This protocol provides substantial vertigo control and hearing stabilization, and may be adopted as a first-line strategy before considering surgical options.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1582-1588"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148203830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Analgesic Efficacy of Extended Opioid-free Anesthesia Regimen with Intravenous Lignocaine versus Morphine Following Major Head and Neck Surgeries.","authors":"Sunil Rajan, Gayathri Sreekumar, Maharnab Bhuyan, Fazil Haleel, Maneesh Sheela Manikandan, Jerry Paul","doi":"10.4103/aam.aam_437_25","DOIUrl":"10.4103/aam.aam_437_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Opioids are commonly used for postoperative analgesia, but concerns about their potential link to cancer progression and metastasis have led to interest in opioid-free regimens. Intravenous lignocaine, with its analgesic and potential anticancer properties, is emerging as an alternative. We aimed to compare the incidence of inadequate postoperative analgesia and the need for rescue medications between intravenous lignocaine and morphine following major head and neck surgeries.</p><p><strong>Methods: </strong>This retrospective observational study included 40 adult patients who had undergone major head and neck surgeries with reconstruction, divided into two groups. Group M received morphine 0.02 mg/kg/h infusion, and Group L received lignocaine 0.5 mg/kg/h infusion for postoperative analgesia. Data on hemodynamic responses, rescue analgesic use, and ventilation duration were extracted from electronic medical records and intensive care unit nurses' charts. Inadequate analgesia was defined as a >20% increase in heart rate or mean arterial pressure (MAP) from baseline.</p><p><strong>Results: </strong>Group L showed a significantly lower incidence of inadequate analgesia (20%) compared to Group M (20% vs. 80%, P = 0.0002). Patients in Group L required significantly less rescue clonidine (P < 0.001) and had significantly lower total dexmedetomidine consumption and duration of infusion. Mean heart rate and MAP were significantly higher in Group M at various postoperative time points. Postoperative ventilation duration was comparable between the groups.</p><p><strong>Conclusion: </strong>Intravenous lignocaine significantly reduced inadequate analgesia and need for rescue medications with optimal hemodynamics in the immediate postoperative period following major head and neck surgeries. Further large-scale, prospective, randomized controlled trials are warranted.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":"25 6","pages":"1711-1715"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attitude and Perception of Medical Graduates on Medical Ethics: A Cross-sectional Study.","authors":"Padmakumar Krishnankutty Nair, Viji Krishnan","doi":"10.4103/aam.aam_382_25","DOIUrl":"10.4103/aam.aam_382_25","url":null,"abstract":"<p><strong>Aim: </strong>The study aims to understand the current levels of knowledge and attitude of medical graduates toward medical ethics.</p><p><strong>Methods: </strong>A questionnaire-based cross-sectional study was conducted among 138 medical graduates via Google Forms. The collected data were analyzed using SPSS v20 and expressed as frequency and percentages.</p><p><strong>Results: </strong>Among the 138 medical graduates with a mean age of 26.25 ± 2.55 years, the vast majority (94.2%) of participants believe that medical ethics is either significant or highly significant in clinical practice. 57.2% medical graduates feel moderately assured about resolving ethical dilemmas, 97.8% agree or strongly agree that medical ethics should be an integral part of the medical curriculum. Most respondents (80.4%) felt they handled the ethical dilemmas adequately, indicating a general sense of competence despite the challenges faced. 39.9% participants believe the current medical curriculum does not provide sufficient training in medical ethics.</p><p><strong>Conclusion: </strong>This study concludes positive attitudes among medical graduates toward medical ethics and their perceived competence in handling ethical dilemmas. The insights from the study underscore the importance of contextually relevant and integrated approaches to teaching medical ethics that can better prepare graduates for the ethical challenges they will face in their professional lives.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1405-1410"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145443735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Mast Cells in Assessing the Degree of Fibrosis in Histopathological Scoring of Extrahepatic Biliary Atresia.","authors":"Neema Tiwari, Jyotsna Madan, Devajit Nath, Umesh Shukla","doi":"10.4103/aam.aam_411_25","DOIUrl":"10.4103/aam.aam_411_25","url":null,"abstract":"<p><strong>Introduction: </strong>Extrahepatic biliary atresia (EHBA) is a fibroinflammatory disorder characterised by the fibrosed development of extrahepatic biliary ducts, resulting in cholestatic jaundice. Inflammation and inflammatory cytokines have been implicated as causative factors in the development of fibrosis. The disease, in essence, is a rare entity with an incidence varying from 1 in 5000 to 1 in 18,000 live births in India. The role of inflammatory cells, such as mast cells, in causing fibrosis in liver biopsies is being researched in recent times to determine their impact on patient prognosis.</p><p><strong>Aims and objectives: </strong>The aim of the study was to assess the number of mast cells in cases diagnosed as EHBA and correlate that with the degree of fibrosis and other histopathological findings in order to indicate the role of mast cells as fibrogenic inflammatory mediator.</p><p><strong>Material and methods: </strong>The department of pathology carried out a retrospective observational study on 7 cases of suspected EHBA, in samples received from cases with ages from 8 weeks to 2 years, which were sent to the lab from the department of pediatric surgery. Extrahepatic biliary atresia was confirmed by histopathological examination of the liver biopsy specimen and intraoperative cholangiography taken during Kasai's portoenterostomy. Multiple stains were done on sections, and the common scoring systems mentioned by Lee.WS and Russo P in their respective papers, were used in reporting the cases for EHBA. Fibrosis was scored as per the modified Scheuer's system.</p><p><strong>Results: </strong>All the cases showed similar findings with a fair number of mast cells, variable degree of fibrosis accompanying inflammation, biliary bile plugs and degeneration in the hepatocytes. A positive trend was noted between an increase in mast cells and the degree of fibrosis in the biopsies, which were reported out as EHBA. Eosinophils were present in all the cases analyzed.</p><p><strong>Conclusion: </strong>Presence of Mast cells in all cases of EHBA with an increasing number of mast cells with a higher degree of fibrosis can be a potential or probable indicator of prognosis and scoring in EHBAs, however in view of the study being a pilot study with a small sample size, a larger cohort with control arm needs to be studied to confirm the findings of our study.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1602-1607"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Students' Perceptions of Small Group Teaching versus Lecture-based Teaching in a Resource-limited Setting: A Pilot Study from India.","authors":"Sudha Rani, Govind Kumar Gupta, Santosh Kumar, Zikra Ain","doi":"10.4103/aam.aam_496_25","DOIUrl":"10.4103/aam.aam_496_25","url":null,"abstract":"<p><strong>Background: </strong>Medical education is evolving toward interactive teaching methods, and small group teaching (SGT) is increasingly being adopted. While lecture-based teaching using PowerPoint (LBTP) remains common, its effectiveness in fostering student engagement, retention, and critical thinking is being questioned.</p><p><strong>Objective: </strong>To compare students' perceptions of SGT versus LBTP among Indian medical undergraduates.</p><p><strong>Methods: </strong>A cross-sectional, within-subject, comparative pilot study was conducted among 100 undergraduate medical students at Sheikh Bhikhari Medical College, Hazaribagh, India. The same topic was taught using two approaches: SGT (15-17 students per group, divided into six groups) and LBTP (a whole-class PowerPoint lecture). Feedback was collected via a semistructured questionnaire using Google Forms. Responses were analyzed using descriptive statistics and Chi-square tests ( P < 0.05 was considered statistically significant).</p><p><strong>Results: </strong>Of the 100 students, 98 completed the questionnaire. Most students (85%) rated SGT as more effective, particularly for understanding and engagement. Knowledge retention was higher with SGT (62.2%) compared to LBTP (11.2%). Strengths of SGT included better interaction, clarity, peer learning, and personalized feedback.</p><p><strong>Conclusion: </strong>SGT was perceived as more effective than LBTP. These findings support the integration of interactive, learner-centered methods in resource-limited medical education contexts, such as those found in many parts of Sub-Saharan Africa and South Asia.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1734-1738"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Incidence of Thyroidectomy-induced Recurrent Laryngeal Nerve Injuries and Their Risk Factors Using Acoustic Analysis: An Observational Study.","authors":"Karim Heiba, Talha Ahmed, Amr Mohsen, Sumith Marian Colaco, Mostafa Elshazly, Aisha Abdel-Hady, Ahmed Nabil","doi":"10.4103/aam.aam_310_25","DOIUrl":"10.4103/aam.aam_310_25","url":null,"abstract":"<p><strong>Background: </strong>Thyroidectomy is one of the most common operations performed, with recurrent laryngeal nerve injury (RLNI), both complete and incomplete, being one of the most serious potential complications. In this study, we used acoustic analysis of jitter, shimmer, noise-to-harmonic ratio (NHR), and maximum phonation time (MPT) as an objective method of diagnosing RLNI.</p><p><strong>Materials and methods: </strong>We evaluated the mean values of jitter, shimmer, NHR, and MPT in patients undergoing thyroidectomy. These values, in addition to laryngoscopy, were measured preoperatively, at 1 week post operatively, and at 3 months postoperatively.</p><p><strong>Results: </strong>The values of jitter, shimmer, NHR, and MPT were all raised in the first postoperative follow up; however, jitter, shimmer, and NHR were significantly raised ( P < 0.001) in patients whose recurrent laryngeal nerve (RLN) was not identified intraoperatively in comparison to those where it was identified. All of these parameters returned to near-normal levels at 3 months postoperatively.</p><p><strong>Conclusion: </strong>Identification of the RLN intraoperatively during thyroidectomy significantly decreased the incidence of its injury both completely and incompletely. The use of acoustic analysis is an objective way of measuring incomplete injury of the RLN postoperatively.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1608-1613"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148025839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review and Meta-analysis on the Prevalence of Common Hemoglobinopathies in India.","authors":"Soumyajit Das, Glory Ghai, Shruthy Sathianath, S Savitha, S Sumathi, Felista Karen Joseph, Prakasini Satapathy, Aravind P Gandhi","doi":"10.4103/aam.aam_464_25","DOIUrl":"10.4103/aam.aam_464_25","url":null,"abstract":"<p><strong>Context: </strong>In India, hemoglobinopathies such as beta-thalassemia, sickle cell disease, and glucose-6-phosphate dehydrogenase (G6PD) deficiency are major public health concerns.</p><p><strong>Aims: </strong>The present meta-analysis aimed to aggregate data on the prevalence and distribution of these nationally significant hemoglobinopathies across various demographic segments of India.</p><p><strong>Materials and methods: </strong>The systematic review adhered to PRISMA 2020 guidelines. Four databases - Web of Science, PubMed, ProQuest, and Embase - were searched till 12.05.2024. Risk of bias assessment studies were undertaken using the JBI Critical Appraisal Checklist.</p><p><strong>Statistical analysis used: </strong>Pooled estimate of prevalence of each hemoglobinopathies and their traits was calculated with 95% confidence interval (CI). I2 statistics and the prediction interval were calculated to depict the heterogeneity. All statistical analyses were done in R studio.</p><p><strong>Results: </strong>Database search yielded 1418 articles, among which 99 studies were finally included. Pooled prevalence of sickle cell anemia from 656,005 participants was 2% (95% CI: 1%-3%, I2 = 99.6%). Pooled prevalence of sickle cell trait was 5% (95% CI: 2%-8%, I2 = 99.9%). Pooled prevalence of beta thalassemia was 6% (95% CI: 2%-12%, I2 = 99.9%). Pooled prevalence of beta thalassemia trait was 7% (95% CI: 4%-9%, I2 = 99.6%). Pooled prevalence of G6PD deficiency was 5% (95% CI: 3%-8%, I2 = 98.8%). Subgroup analysis revealed varying prevalence of hemoglobinopathies across the regions and states.</p><p><strong>Conclusions: </strong>The study findings highlight the burden and subsequent need for region-specific (decentralized) strategies for managing hemoglobinopathies. Addressing the burden through early diagnosis, genetic counseling, and public health interventions is crucial in reducing morbidity and improving health outcomes.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1625-1641"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147626581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Addition of Saroglitazar to Lifestyle Modifications in Patients with Nonalcoholic Fatty Liver Disease: A Prospective Observational Study.","authors":"K Ragottham, N Mukunda, L V Lokesh","doi":"10.4103/aam.aam_454_25","DOIUrl":"10.4103/aam.aam_454_25","url":null,"abstract":"<p><strong>Objective: </strong>Nonalcoholic fatty liver disease (NAFLD) is a prevalent metabolic disorder with significant health implications. This study aims to evaluate the effect of adding Saroglitazar to lifestyle modifications in improving NAFLD-related parameters compared to lifestyle modifications alone.</p><p><strong>Methodology: </strong>A prospective observational study was conducted at the Outpatient Department of Gastroenterology, M. S. Ramaiah Hospitals, including patients diagnosed with NAFLD. Patients were divided into two groups: Group 1 received lifestyle modification counseling, and Group 2 received Saroglitazar 4 mg OD in addition to lifestyle modification counseling for 12 weeks. Liver function tests and ultrasonographic findings were assessed at baseline and after 12 weeks.</p><p><strong>Results: </strong>A statistically significant improvement ( P = 0.02) in alanine transaminase (ALT) levels was observed within the treatment Group 2, along with a trend of improvement in aspartate transaminase (AST) levels ( P = 0.07). However, no significant difference in AST and ALT levels was found between the groups. Ultrasonographic improvements were noted in few patients receiving Saroglitazar, and the drug was well tolerated, with minor adverse events such as nausea and fatigue.</p><p><strong>Conclusions: </strong>The addition of Saroglitazar to lifestyle modifications showed a beneficial effect in improving NAFLD-related parameters over 12 weeks compared to lifestyle modifications alone.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1730-1733"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Ease of Awake Intubation Using Traditional Fibreoptic Bronchoscope Versus Hybrid Technique with Videolaryngoscopic Assistance in Patients with Difficult Airway.","authors":"Mahesh Madhu, Sunil Rajan, Fazil Haleel, Gayathri Sreekumar, Lokeshshiva Arul, Maharnab Bhuyan","doi":"10.4103/aam.aam_408_25","DOIUrl":"10.4103/aam.aam_408_25","url":null,"abstract":"<p><strong>Background and aims: </strong>Difficult airways pose a significant challenge for intubation. While video laryngoscopes and fiberoptic bronchoscopes (FOB) are effective, they have limitations when used alone. A hybrid technique combining both may improve success. Our study's primary objective was to compare intubation time between a traditional fiberoptic method versus a hybrid videolaryngoscopic technique in patients with difficult airways. Secondary objectives included assessing ease of intubation, number of attempts, and patient comfort.</p><p><strong>Methods: </strong>This prospective, randomized, observational study enrolled 60 patients with a difficult airway. The airway of patients was topicalized, and those having a percentage of glottic opening score 0 with C-MAC videoscope during awake check laryngoscopy were included in the study. Patients were randomized into two groups: Group F was intubated by traditional awake fiberoptic intubation (AFOI). Awake intubation in Group H was performed using a hybrid technique (FOB with C-MAC videolaryngoscopic assistance). Time to intubate, ease of intubation, number of attempts, and patient comfort score were noted.</p><p><strong>Results: </strong>Mean time to intubation was significantly shorter in Group H (35.57 ± 13.984 s) compared to Group F (76.80 ± 26.484 s, P < 0.001). Intubation was \"Easy\" in 86.7% of Group H patients versus 33.33% in Group F ( P < 0.001). The number of intubation attempts and hemodynamic stability were comparable between groups. However, patient comfort was significantly higher in Group F, with 70% reporting no reaction compared to 23.33% in Group H ( P < 0.001).</p><p><strong>Conclusion: </strong>The hybrid technique of AFOI with videolaryngoscopic assistance significantly reduced time and improved ease of intubation, though with reduced patient comfort.</p>","PeriodicalId":7938,"journal":{"name":"Annals of African Medicine","volume":" ","pages":"1576-1581"},"PeriodicalIF":1.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}