https://aijournals.com/index.php/aan/issue/feed Academia Anesthesiologica International 2022-01-19T11:08:42+00:00 Dr. Rohit Varshney drrohit.editor@gmail.com Open Journal Systems <p><strong class="pull-left">Academia Anesthesiologica International </strong>is a double-blinded peer-reviewed, open access, Bi-annual, online journal that publishes original research articles, review articles, case reports, brief communications and clinical studies in all areas/advances of anesthesia, pain and intensive care. <br><strong>Online ISSN: 2456-7388 | Print ISSN:&nbsp;2617-5479</strong></p> https://aijournals.com/index.php/aan/article/view/2167 Evaluation of Propofol as Procedural Sedative Agent for Ease of Induction of Spinal Anesthesia in Patients Undergoing Abdominal Surgeries 2021-12-31T11:50:21+00:00 Manasa S manassubindu28@gmail.com Yuvaraj M K yuvaraj.bmc@gmail.com Pradeep Hosagoudar drpaddy82@gmail.com <p><strong>Background: </strong>Sometimes it is difficult to position the patients for spinal anaesthesia. Poor positioning causes discomfort to both anesthesiologist and patient. It may also lead to, autonomic fluctuations. Providing procedural sedation may alleviate those undesired difficulties. In this study, we are evaluating propofol as procedural sedative agent for ease of induction of spinal anaesthesia. <strong>Subjects and Methods: </strong>This prospective study was conducted among 60 patients who were randomly divided into 2 groups. Group A received Inj Propofol 0.7mg/kg as procedural sedative agent prior to spinal anaesthesia, Group C did not receive any procedural sedative drugs. Ease of identification of space, time to induce spinal anaesthesia, number of attempts, patient comfort score, patient satisfaction score were recorded and analyzed. <strong>Results: </strong>Demographic data were comparable between the groups, there was no statistically significant difference between the groups in terms of ease of identification of space, number of attempts, patient comfort score and patient satisfaction score. Time to induce spinal anaesthesia was longer in Group A (35.53 15.39) and it was statistically significant compared to Group C. <strong>Conclusion: </strong>Using Propofol as procedural sedative agent may not significantly ease the induction of spinal anesthesia in patients undergoing abdominal surgeries compared to patients without sedation</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Author https://aijournals.com/index.php/aan/article/view/2174 Evaluation of Ketamine-midazolam as Procedural Sedative Agent for Ease of Induction of Spinal Anesthesia in Patients Undergoing Abdominal Surgeries 2022-01-03T13:42:39+00:00 Manasa S manassubindu28@gmail.com Yuvaraj M K yuvaraj.bmc@gmail.com Pradeep Hosagoudar drpaddy82@gmail.com <p><strong>Background: </strong>Most of the patients are anxious during induction of spinal anesthesia may lead to poor positioning, autonomic fluctuations. Pro- viding procedural sedation may alleviate those undesired difficulties. In this study, we evaluated intravenous ketamine-midazolam combination as procedural sedative agent for ease of induction of spinal anaesthesia. <strong>Subjects and Methods: </strong>This prospective study was conducted among 60 patients who were randomly divided into 2 groups. Group K received Inj Ketamine 0.5mg/kg with Inj Midazolam 0.02mg/kg as procedural sedative agent prior to spinal anaesthesia, Group C did not receive any procedural sedative drugs. Ease of identification of space, time to induce spinal anaesthesia, number of attempts, patient comfort score, patient satisfaction score was recorded and analyzed. <strong>Results: </strong>Demographic data were comparable between the groups, there was no statistically significant difference between the groups in terms of ease of identification of space, number of attempts, time to induce spinal anaesthesia. Patient comfort score was significantly higher in group K compared to group C (9.17 0.59 and 7.13 1.20 respectively). Patient satisfaction score was higher in group K than group C (95.33 7.30 and 71.67 12.27&nbsp; respectively). <strong>Conclusion: </strong>Intravenous Ketamine-midazolam as procedural sedative agent may not significantly ease the induction of spinal anesthesia compared to patients without sedation. However, it resulted in better satisfaction and comfort to the patient than without sedation.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Author https://aijournals.com/index.php/aan/article/view/2175 Heart Rate Response in Conventional Nasal Vs Fiber Optic Bronchoscopic Endotracheal Intubation Techniques in Oral & Maxillofacial Surgery 2022-01-03T13:49:00+00:00 Archna Sharma drarchanasharma1991@gmail.com Manish Kumar Sharma manishsharmamfos@gmail.com Ajay Sood ajay_5644@yahoo.com Dara Singh dara_negi556@hotmail.com <p><strong>Background: </strong>Present study was conducted to compare the change in heart rate between conventional nasal intubation and flexible fiberoptic nasal intubation in oral and maxillofacial surgeries. <strong>Subjects and Methods: </strong>Sixty consenting adult patients, of either sex, of ASA physical status 1 and 2, in the age group of 18-60 years coming for oral and maxillofacial surgery were included in the study. These patients were randomly divided into two groups of 30 patients, each for either conventional nasal endotracheal intubation (Group A) or nasal intubation using flexible fiberoptic bronchoscope (Group B). <strong>Results: </strong>When heart rate was compared between the two groups we found that heart rate was comparable in both the groups. <strong>Conclusions: </strong>From our study, we concluded that there is no advantage of flexible fiberoptic intubation over conventional nasal intubation in terms of increase in heart rate.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Author https://aijournals.com/index.php/aan/article/view/2176 A Comparative Evaluation of Pressure Response in Conventional Nasal Vs Fiber Optic Bronchoscopic Endotracheal Intubation Techniques in Oral & Maxillofacial Surgery 2022-01-03T14:01:05+00:00 Archna Sharma drarchanasharma1991@gmail.com Manish Kumar Sharma manishsharmamfos@gmail.com Ajay Sood ajay_5644@yahoo.com Dara Singh dara_negi556@hotmail.com <p><strong>Background: </strong>The purpose of the present study was to compare the blood pressure response between conventional nasal and flexible fiber optic techniques. <strong>Subjects and Methods: </strong>After taking approval of the hospital ethical committee on research, 60 consenting adult patients, of either sex, of ASA physical status 1 and 2, coming for oral and maxillofacial surgery were included in the study. These patients were randomly divided into two groups of 30 patients, each for either conventional nasal endotracheal intubation (Group A) or nasal intubation using flexible fiber optic bronchoscope (Group B). <strong>Results: </strong>When mean arterial pressure (MAP) was compared between both the groups, we found that at 1 minute after intubation, the increase in MAP was more in group B (fiber optic bronchoscope group), which was significant. Also time taken for intubation with fiber optic technique was significantly more than conventional nasal intubation. <strong>Conclusions: </strong>From our study, we concluded that fiber optic bronchoscopy provides no advantage over conventional laryngoscopy, in terms of decreasing the pressure response to nasotracheal intubation. However, fiber optic intubation remains gold standard technique for difficult airway.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Author https://aijournals.com/index.php/aan/article/view/2178 Comparison of LMA Supreme and Endotracheal tube in Laparoscopic Cholecystectomy 2022-01-10T05:59:35+00:00 Amit Srivastava docamitsrivastava@gmail.com Manoj Tripathi georgian.manojt@gmail.com Sujeet Kumar drsujeetrai@gmail.com Smarika Mishra mishra.smarika1991@gmail.com Mahendra Singh drmahensng@gmail.com Brihaspati Tiwari bt09brdgkp@gmail.com <p><strong>Background: </strong>Second generation Supraglottic airway devices such as LMA-S have enhanced features to answer some of the concerns raised due to laparoscopic abdominal procedures. The present study was undertaken to compare the efficacy and safety of LMA-Supreme (LMA-S) and Endotracheal Tube (ETT) in patients undergoing laparoscopic cholecystectomy in general anesthesia. <strong>Subjects and Methods: </strong>60 patients were randomly allocated into two groups of 30 each. In group 1&amp; 2, we have used LMA-S and ET tube for securing airway. We have assessed time used in device insertion, difficulty in insertion, heart rate, MAP, SPO2, intraabdominal pressure variation, ventilatory parameters and side effects. <strong>Results: </strong>We had found significant difference of heart rate and MAP between the groups at different times (p&lt;0.05). Time taken for insertion of device was significantly less in group 1 than&nbsp; group 2 (14&nbsp; 2 vs 18.2&nbsp; 2, p&lt;0.001). Side effects&nbsp; were&nbsp; found comparable&nbsp; between the groups. <strong>Conclusion: </strong>LMA-S and Endotracheal Tube (ETT) both of them show similar efficacy during laparoscopic surgery under general anaesthesia and controlled ventilation. So LMA-S can be used as a effective alternate to ET tube.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Author https://aijournals.com/index.php/aan/article/view/2179 A Randomized Double Blind Comparative Study of Intravenous Magnesium Sulphate and Intravenous Lignocaine for Attenuation of Haemodynamic Response to Laryngoscopy and Tracheal Intubation 2022-01-10T06:09:15+00:00 Penke S.V. Ramarao penkerams1@yahoo.co.in T. Ramesh Kumar drtrameshkumar2@gmail.com D. Venkatesh drdvenkatesh1988@gmail.com <p><strong>Introduction: </strong>Endotracheal intubation has become a standard part of anaesthesia and critical care management. All of these operations can cause sympathetic responses, and it’s important to remember that many of these patients are extremely ill and at risk. The aim is to compare the efficacy of intravenous Magnesium sulphate with intravenous Lignocaine hydrochloride in attenuation of cardiovascular responses to laryngoscopy and intubation. <strong>Subjects and Methods : </strong>A Prospective Randomized Double Blind Study. The study was done in General Operation Theatre Complex of the Tirumala Hospitals, Vizianagaram, Andhra Pradesh.70 Patients, 35 in each group. The study comprised patients who were scheduled for ASA class I and II elective surgical operations under general anaesthetic. <strong>Results: </strong>Percent rise in the HR, SBP, DBP, and MAP were significantly less in Group B(magnesium) compared to Group A(lignocaine). MgSO<sub>4</sub> 30mg/kg given intravenous 90 seconds prior to laryngoscopy and intubation for attenuation of pressor response results in significant reduction in HR, SBP, DBP and MAP at 1 min after laryngoscopy and intubation and no significant changes after 3 min when compared to intravenous lignocaine 1.5mg/kg. <strong>Conclusion: </strong>Intravenous magnesium sulphate 30mg/kg 90 seconds prior to laryngoscopy and intubation is superior to lignocaine 1.5mg/kg prior to laryngoscopy and intubation.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Author https://aijournals.com/index.php/aan/article/view/2180 A Prospective Randomized Study of Local Infiltration of Two Different Concentrations of Ropivacaine for Postoperative Analgesia in Inguinal Hernia Repair 2022-01-19T09:06:51+00:00 Macha Niranjan Reddy tillureddy1@gmail.com Payal Jain payalravi1408@gmail.com Mukesh Kumar Prasad mukeshkumar2002@gmail.com Gurdeep Singh Jheetay jheetay.gs@gmail.com Razi Shahid razishahid7866@gmail.com <p><strong>Background: </strong>Postoperative pain management by surgical site infiltration has an edge over other methods of analgesia as it is simple and&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; has lesser side effects. This study was designed to compare the analgesic effects provided by two&nbsp; different concentrations 0.25% and 0.50%&nbsp;&nbsp; of Ropivacaine, a new amino amide local anesthetic agent. <strong>Subjects and Methods: </strong>Ninety six patients in each group scheduled for elective inguinal herniorrhaphy were randomly allocated by chit and box method to Group A(0.50%) and Group B(0.25%), spinal anesthesia was given. The surgical site was infiltrated after the end of surgery with 20 ml of drugs; Ropivacaine 0.5% in group A, Ropivacaine 0.25% in group B. Postoperatively hemodynamics were recorded from every 0 h to until 12 h. Postoperatively, rest pain, pain on coughing, and pain on movements were assessed using visual analog scale (VAS) score immediately at the end of the surgery and 2 hourly up to 12 h. The time of the first request for rescue analgesia was noted. <strong>Results: </strong>VAS scores at rest(P&lt;0.027*), during coughing(P&lt;0.001) and movements (P&lt; 0.04) were higher in group B 0.25% and the time of rescue analgesia was higher with group B 0.25% when compared with other group A (P&lt;0.001). <strong>Conclusion: </strong>Ropivacaine as an anesthetic in inguinal hernia repair for surgical infiltration is safe and effective in pain reduction, with very few adverse reactions at the concentration of 0.5%.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Author https://aijournals.com/index.php/aan/article/view/2196 Clinical Assessment of Cardiovascular Effects and Intubating Conditions with Rocuronium, Vecuronium, and Suxamethonium 2022-01-15T11:23:03+00:00 Chinta Ramesh dr.ramesh.chinta@gmail.com Varaprasad P Dora prasadanaesthesia@gmail.com D.S.S.K. Raju dsskraju@gmail.com <p><strong>Background: </strong>Achieving muscle relaxation during endotracheal intubation is a vital requirement and needs drugs safer than suxamethonium that is early-onset, long duration, stable hemodynamic parameter, minimum side effects, and good intubating conditions. The aims the present study was conducted to evaluate cardiovascular effects and intubating conditions of drug rocuronium compared to vecuronium and suxamethonium. <strong>Subjects and Methods: </strong>A total of 120 subjects were randomly divided into 3 groups of 40 subjects each depending on muscle relaxant given during intubation as Group I with 0.6 mg/kg rocuronium, Group II with 1.5 mg/kg suxamethonium, and Group III with 0.08 mg/kg vecuronium. Premedication was done with 0.2 mg glycopyrrolate and the anesthetic agent used was 4-5 mg/kg thiopentone sodium 2.5% along with the intermitted injection of vecuronium. Parameters assessed were fasciculations, cardiovascular response, limb movement, coughing, vocal cord movement and position, jaw relaxation, and apnoea onset. <strong>Results: </strong>For Group I, onset was longer compared to Group II, however, it was lesser than Group III. No fasciculation was seen in Group I and III but was seen in Group II. Better intubating conditions were seen in Group III.&nbsp;&nbsp;&nbsp; No complication was seen in any subject from any group. <strong>Conclusion: </strong>The present study concludes that rocuronium is an effective and safer alternative to suxamethonium in tracheal intubation cases in subjects not needing rapid spontaneous respiration return. Hence, it can act as a filler between non-depolarizing neuromuscular blocking agents and suxamethonium and can be considered as the ideal neuromuscular agent.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Author https://aijournals.com/index.php/aan/article/view/2197 Comparison of Brachial Plexus Block Performed by Axillary Approach and Coracoid Infraclavicular Block for Upper Limb Surgery: A Clinical Study 2022-01-15T11:30:47+00:00 Varaprasad P Dora prasadanaesthesia@gmail.com Chinta Ramesh dr.ramesh.chinta@gmail.com D.S.S.K. Raju dsskraju@gmail.com <p><strong>Background: </strong>PNBs (Peripheral Nerve Blocks) have a vital role with increasing attention in subjects undergoing ambulatory anesthesia. PNBs also have properties near to ideal anesthesia in Outpatient surgical cases. It is also associated with facilitated discharge and postoperative analgesia. The aims of the present study were conducted to compare the efficacy of brachial plexus block given by Coracoid infraclavicular route or axillary route with peripheral nerve stimulator concerning success and failure rates, block duration, motor block intensity, onset, and performance time. <strong>Subjects and Methods: </strong>The study included a total of 50 subjects from both genders divided into two groups of 25 subjects each given brachial plexus block using either coracoid route or axillary route. The local anesthetic agent used was 2% lidocaine with 0.5% bupivacaine mixed in equal parts for all the subjects. <strong>Results: </strong>It was seen that the axillary approach was better in efficacy concerning few incomplete blocks, more comfort, less pain, long duration, more intensity, and fast onset with 4 injections of local anesthetic agents compared to the two injections used in the coracoid approach. The long duration helped in achieving better postoperative analgesia. However, the coracoid approach was advantageous in subjects with arthritis and stiff shoulder joints as it could be given in an arm in a neutral position. <strong>Conclusion: </strong>The present study concludes that the axillary approach using four injections is more efficacious than two injections of the coracoid approach in terms of long duration, faster onset, and better analgesia.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Author https://aijournals.com/index.php/aan/article/view/2198 Sevoflurane Anaesthesia and Propofol Based Anaesthesia- A Comparative Study 2022-01-16T05:25:22+00:00 Imran Nazir imran_nazir97@yahoo.com Masarat Ara masaratbhat86@gmail.com Tufail Ahmad Sheikh tufail.ahmad99@gmail.com <p><strong>Background: </strong>Total intravenous anaesthesia (TIVA) is a technique of anaesthesia which involves use of intravenous drugs to anaesthetize the patient without the use of inhalational agents. The present study was conducted to compare sevoflurane (inhalational) anaesthesia and propofol (Tiva) based anaesthesia. <strong>Subjects and Methods : </strong>80 ASA I and II patients, aged 18-65 years of either sex undergoing surgery under general anaesthesia were randomly divided into two groups. Group I received sevoflurane inhalational induction via a vital capacity rapid inhalational induction (VCRII) technique using 8% sevoflurane. Group II patients were induced with propofol i.v 2-2.5mg/kg. Parameters such as MAP and recovery profile was recorded in both groups. <strong>Results: </strong>Group I comprised of 22 males and 18 females and group II had 16 males and 24 females. The mean MAP (mmHg) in group I and II was 100.5 and 102.1, before induction was 98.2 and 97.7, after induction was 89.0 and 88.4, 5 minutes after intubation was 93.4 and 91.0, at 15 minutes was 100.1 and 97.8, at 30 minutes was 100.0 and 99.3 and at 45 minutes was 100.9 and 99.1 respectively. The recovery profile such as time of spontaneous eye opening was 9.5 minutes in group I and 13.2 minutes in group II, time to verbal communication was11.5 minutes in group I and14.3 minutes in group II and time to mental orientation was 15.6 minutes in group I and</p> <p>19.0 minutes in group II. The difference was significant (P&lt; 0.05). <strong>Conclusion: </strong>Sevoflurane is better than propofol in terms of faster induction and rapid recovery.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Author https://aijournals.com/index.php/aan/article/view/2206 Comparison Between the Intravenous Ramosetron and Ondansetron in Prevention of Post-Operative Vomiting and Nausea in Adults Under General Anesthesia 2022-01-19T09:58:41+00:00 Ashish B Shah ashishshah353@yahoo.com Richa Gupta dr.richagupta91@gmail.com <p><strong>Background: </strong>Present study was performed as randomized controlled trial to contrast the therapeutic efficiency of ramosetron and ondansetron for the management of recognized PONV in Subjects subsequent surgery under general anesthesia. <strong>Subjects and Methods: </strong>The Subjects will be separated into 2 groups of 100 each, in a random, single blinded mode. Group I received Ramosetron 0.3 mg I.V and Group II received Ondansetron 4 mg I.V. Postoperatively, Subjects were calculated for episodes of nausea, retching and vomiting and the need for rescue antiemetic at intervals of 0-2 hours, 2 -12 hours, 12 - 24 hours and 24 - 48 hours. <strong>Results: </strong>In this study, complete response was noted to be 60% in the Ondansetron group and 82% in the Ramosetron group. The requirement of rescue medication was less in the Ramosetron group compared to the Ondansetron group (2% vs. 14%). <strong>Conclusion: </strong>It is concluded from this study that Ramosetron 0.3 mg is safe and well-tolerated and additional effectual than Ondansetron 4 mg in the prevention of postoperative nausea and vomiting.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Author https://aijournals.com/index.php/aan/article/view/2207 A Comparative Study of Ambu Aura-i and Air-Q Supraglottic Airway Devices as Conduit for Blind Tracheal Intubation in Patients with Normal Airway 2022-01-19T10:04:41+00:00 Afroza N. Syed afroza7887@gmail.com Keerti A. Chitgopekar keerti14.chitgopekar@gmail.com Neha Shah nehakinitshah@gmail.com <p><strong>Background: </strong>Aim: To compare Ambu Aura-i and Air-Q supraglottic airway devices (SAD) as conduit for blind tracheal intubation in terms&nbsp; of First attempt and Over-all success rate. <strong>Subjects and Methods: </strong>A total of 176 consenting patients of ASA grade I/II, undergoing elective surgery under General Anaesthesia, requiring endotracheal intubation, were randomised into two groups of 88 each as Group I (Ambu Aura-i) and Group Q (Air-Q ILA). After induction of Anaesthesia, allocated device was inserted, Cuff was inflated, and device was checked for adequate ventilation. Appropriate size PVC endotracheal tube was inserted through SAD. The correct placement was confirmed by capnography and chest auscultation. The SAD was removed with the help of stabilizing rod. Conventional intubation using direct laryngoscopy was done in case of failure after 3 attempts. First attempt success rate and Over-all success rate of intubation derived at the end of study. <strong>Results: </strong>First attempt success rate of intubation was significantly more in Air-Q (21.6%) than Ambu Aura-i (9.1%) p-value= 0.036. Over-all success rate was also more in Air-Q (77.27%) than Ambu Aura-i (60.23%) p-value= 0.022. <strong>Conclusion: </strong>Air-Q can be considered a better conduit for blind tracheal intubation than Ambu Aura-i.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Author https://aijournals.com/index.php/aan/article/view/2208 Randomized Controlled Trial to Evaluate Efficacy of Atracurium and Cis-Atracurum in Patients in Laparoscopic Surgery at Tertiary Care Center 2022-01-19T10:11:14+00:00 Jayendrakumar C. Makwana drjcmakwana@gmail.com Arpit Shah drarpit.shah213@gmail.com Achyut Bharatkumar Faldu drachyutfaldu@gmail.com Pinal Vasani drpinalvasani@gmail.com <p><strong>Background: </strong>Muscle relaxants are used routinely during intubation to relax muscles in the neck and throat, which reduces the risk of injury. They may also be used to relax the chest muscles when an endotracheal tube is used to help mechanical ventilation. This study is designed to compare the efficacy of atracurium and cisatracurium by the means of: Onset of action, Hemodynamic stability and Duration of action. <strong>Subjects and Methods: </strong>Present Experimental Randomized controlled trial was done at the Department of Anaesthesiology, GMERS Medical College, Sola, Ahmedabad from July 2018 to July 2020 in 80 patients aged between 20 and 45 years. Study was performed in 80 patients aged 20-45 years weighted 40-70 kilograms with ASA physical grading 1 and 2 of either sex scheduled for elective laparoscopic surgery. Monitoring – ECG, non-invasive blood pressure, pulse oximetry, temperature and capnography (EtCO2). In operation theatre intravenous cannula of proper size was inserted into the largest vein on the forearm and an infusion of lactated ringer’s solution was started at a rate of 5 ml/kg/hr. Induction – inj. Propofol 2 mg per kg. Patients were divided into 2 groups: Group 1 - 40 patients were given atracurium 0.5 mg per kg for induction. Group 2 - 40 patients were given cisatracurium 0.1 mg per kg for induction. <strong>Results: </strong>No significant difference was found in both of the groups in measures of age, sex and weight. Onset of atracurium’s action is 3 minutes where as that is 5 minutes for cisatracurium. Using the Cooper’s scoring system, we can easily state that vocal cord movement was still present after 3 minutes of administration of cisatracurium whereas it was absent after&nbsp;&nbsp;&nbsp;&nbsp; 3 minutes of administration of atracurium. <strong>Conclusion: </strong>This randomized control study of 80 patients with 40 in each group was performed to evaluate efficacy of atracurium and cisatracurium in patients in laparoscopic surgery. From our results, we can conclude that, Onset of action is faster with atracurium than cisatracurium, Duration of action of cisatracurium is longer than atracurium and Hemodynamic stability is more with cisatracurium than atracurium. So, we can say that efficacy of cisatracurium is more than atracurium.</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Author https://aijournals.com/index.php/aan/article/view/2209 World Conference on Covid and Critical Care 2022-01-19T11:08:42+00:00 W4C aijournal@gmail.com <p><strong>World Conference on Covid and Critical Care</strong></p> <p>&nbsp;</p> 2021-12-31T00:00:00+00:00 Copyright (c) 2021 Author