DR MADHURI S KURDI
@hubballikims.karnataka.gov.in
Professor &Head
Karnataka institute of medical sciences
She has worked in various teaching capacities as lecturer, Asst Prof, Associate Prof in the Dept of Anaesthesia, Karnataka Institute of Medical Sciences (KIMS), Hubli, Karnataka from January 1997. She is working as Professor in the same department since 2006. She took over as Professor and Head of the department on 1st Aug 2021. Her grand undergraduate and post graduate teaching experience is 26 years to date. She is a Post Graduate teacher and guide of the Rajiv Gandhi University of Health Sciences, Bengaluru since 2004. She is postgraduate examiner for several prestigious universities.
KIMS is one of the largest multi-speciality hospitals in North Karnataka. Established in 1957 , it is a Karnataka Government accorded autonomous Institute recognised by the MCI and offering undergraduate courses and a wide array of postgraduate courses in various specialities.
Dr Madhuri Kurdi further did her WHO Fellowship in Neurointensive Care at NIMHANS, Bengaluru in 2003. She completed her A
EDUCATION
Dr Madhuri Kurdi passed MBBS in 1991 & M D Anaesthesiology in 1996, both from B J Government Medical College and Sassoon General Hospitals, Pune, Maharashtra
RESEARCH INTERESTS
Dr Madhuri has a keen interest in research and publications. She has been a peer reviewer for several indexed journals including the Indian Journal of Anaesthesia. She won ISA-IJA Best Peer reviewer Award in 2016-17. She has been working as assistant editor of Journal of Anaesthesiology Clinical Pha
Scopus Publications
Scopus Publications
MadhuriS Kurdi, Pushpa Agrawal, Parna Thakkar, Divesh Arora, SaurabhM Barde, and Kala Eswaran
Medknow
Patient safety, improved quality of care, and better patient satisfaction and functional outcomes are currently the topmost priorities in regional anaesthesia (RA) and all advancements in RA move in this direction. Ultrasonography-guided central neuraxial and peripheral nerve blocks, intracluster and intratruncal injections, fascial plane blocks, diaphragm-sparing blocks, use of continuous nerve block techniques, and continuous local anaesthetic wound infiltration catheters are now topics of popular clinical interest. The safety and efficacy of nerve blocks can be improved with the help of injection pressure monitoring and the incorporation of advanced technology in the ultrasound machine and needles. Novel procedure-specific and motor-sparing nerve blocks have come up. The anaesthesiologist of the current era, with a good understanding of the sonoanatomy of the target area and the microarchitecture of nerves, along with the backup of advanced technology, can be very successful in performing RA techniques. RA is rapidly evolving and revolutionising the practice of anaesthesia.
PavanVithal Dhulkhed, VithalKrishna Dhulkhed, AnushaRamachandra Katti, Madhuri Kurdi, and SukhminderJit Singh Bajwa
Medknow
Understanding the basic concepts and the dynamics of the equation of motion will help the anaesthesiologist and the intensive care physician in gaining an insight into the basics of modern mechanical ventilation. An equation of the type Vt = V0 × (1-e-kt) is often encountered while studying the concepts of mechanical ventilation. This leaves one wondering about the meaning of 'e'. It is explained as the base of a natural logarithm, and the base e as an irrational constant approximately equal to 2. 7182. In medical literature, various physiological mechanisms are explained by using the exponential function e. However, the explanations do not sufficiently help the learner to demystify the enigmatic term e. In this article, an effort is made to explain this function with the help of simple analogies and relevant mathematical concepts. The process of volume build-up in the lungs during mechanical ventilation is used as a model for the explanations.
SukhminderJit Singh Bajwa, MadhuriS Kurdi, and AnilaD Malde
Medknow
New knowledge needs to flow into any speciality of science to keep it vibrant. The flow of new knowledge starts from original research and observations. Novel research questions are tested in research studies and the results bring to light newer and useful strategies that can be applied in clinical practice. The recent advances in a speciality are portrayed by the contents of the journals of that speciality, some of which are translated into clinical practice.
MadhuriS Kurdi, Vennila Rajagopal, SD L Kalyani Sangineni, Murugan Thalaiappan, Anju Grewal, and Sunanda Gupta
Medknow
Newer modalities in labour analgesia and anaesthesia for caesarean section including regional anaesthesia techniques and airway management are emerging constantly. Techniques such as point of care ultrasound, especially of the lungs and stomach and point of care tests of coagulation based on viscoelastometry are about to revolutionise perioperative obstetric care. This has improved the quality of care thereby ensuring good perioperative outcomes in the parturient with comorbidities. Critical care for obstetrics is an emerging field that requires a multidisciplinary approach with obstetricians, maternal-foetal medicine experts, intensivists, neonatologists, and anaesthesiologists working together with enhanced preparedness and uniform protocols. Newer techniques and concepts of understanding have thus been established in the traditional speciality of obstetric anaesthesia over the last decade. These have improved maternal safety and neonatal outcomes. This article touches upon some recent advances that have made a significant impact in the field of obstetric anaesthesia and critical care.
SukhminderJit Singh Bajwa and MadhuriS Kurdi
Medknow
MadhuriS Kurdi, Vijaya Patil, Muthuchellappan Radhakrishnan, and Shwethapriya Rao
Medknow
MadhuriS Kurdi, Madhusudan Upadya, Padmaja Durga, and SumeshT Rao
Medknow
© 2022 Indian Journal of Anaesthesia | Published by Wolters Kluwer Medknow Researchers often claim primacy in their study being first in their country’s populace, pointing to ethnic importance. Race and ethnicity play an important role in disease risks, responses to environmental exposures, access to treatment and health outcomes. An excellent example of this is the Framingham heart study, which found that ethnicity significantly modifies the association between risk factors and cardiovascular events.[1] Similarly, the performance of obstetric comorbidity adjustment indices was tested across race and ethnicity groups in a recent study.[2]
PremanathF Kotur, MadhuriS Kurdi, Kaushik Theerth, and Tushar Chokshi
Medknow
© 2022 Indian Journal of Anaesthesia | Published by Wolters Kluwer Medknow Simulation-based training is rapidly evolving with the changing healthcare landscape and airway training is no exception.To keep pace with the scenario, the field of simulation-based research has grown rapidly over the last decade and two types of simulation-based research studies have been described: 1) Studies that assess the efficacy of simulation as a training methodology (as an educational intervention) and 2) studies where simulation has been used as an investigative methodology.[1] Several articles describing the attributes of simulation-based research and the simulation-based educational interventions are available.[2]
SukhminderJit Singh Bajwa, Rashmi Datta, and MadhuriS Kurdi
Medknow
© 2022 Indian Journal of Anaesthesia | Published by Wolters Kluwer Medknow India being a country of diversity, diverse aspects can be seen in everything: her culture, beliefs, seasons, festivals, religions, food habits, clothing and so on. The healthcare practices too are diverse, and this includes perioperative medicine.[1] Though the surgical techniques and the perioperative management are evidence-based, there are several gaps in this area, which need to be worked upon. One of these is the issue of ordering preoperative investigations. Numerous subjective and documented incidences can be counted where the surgical fraternity gets frustrated by the investigations ordered by the anaesthesiologist. These kinds of skirmishes and conflicts with complaints about ‘unnecessary’ ordering of preoperative investigations throng the desks of the administrators of hospitals and heads of anaesthesia departments. Then, there is another group of the surgical fraternity who get ‘A to Z’ investigations [from haemoglobin (Hb) to 2D echocardiography] done just to avoid the postponement of cases apart from getting a protective shield against medico-legal litigations. The picture of the surgical/obstetrics and gynaecology resident getting scolded by the seniors for not having got the laboratory investigations done preoperatively is familiar to most of us! The most important and common thing that surgeons fear is the postponement of the scheduled case by the anaesthesiologist due to a lack of a particular preoperative investigation or an abnormal preoperative laboratory investigation value. It can be concluded from here that ‘not– really indicated’ investigations are done many a time. Many studies have shown that 2/3rd of the ordered preoperative investigations are not necessary and that there is a high prevalence of superfluous preoperative testing for healthy patients of American Society of Anesthesiologists physical status (ASA PS) I and II undergoing elective surgical procedures.[2-4] Also, the ordering of preoperative investigations by anaesthesiologists is more rational and pertinent than that by surgeons.[4] The situation of a beginner consultant anaesthesiologist being forced to give a surgical case without the ‘required preoperative investigations’ is pitiable. Which investigation is ‘required’ and which is not ‘required’ is the million-dollar question. The preoperative investigation practices vary from centre to centre and sometimes, between anaesthesiologists in the same institute and for different patient populations. The variable dietary patterns, disease patterns, clinical presentations and comorbidities add colour to this regionalism and diversity in the ordering of preoperative investigations.
Deepak Malviya, SukhminderJit Singh Bajwa, and MadhuriS Kurdi
Medknow
© 2022 Indian Journal of Anaesthesia | Published by Wolters Kluwer Medknow Risks are common in all walks of life, especially in the finance market, wherein the risk relates to the odds of losing the money, whereas in the perioperative and health sector, risk entails compromising the safety of the patient, and thereby enhancing the morbidity and mortality. The finance sector has seen wide application of algorithmic scoring methods to prevent risk and to optimise decisions.[1] Similarly, risk assessment tools (RATs) such as risk scores and risk prediction models (RPMs) have made their mark in perioperative medicine and critical care. A number of RPMs have been formulated, and perioperative risk prediction has now become an important component of the enhanced recovery after surgery (ERAS) pathway and a significant strategy to improve the perioperative quality of care.[2]
SukhminderJit Singh Bajwa, Lalit Mehdiratta, and MadhuriS Kurdi
Medknow
© 2021 Indian Journal of Anaesthesia | Published by Wolters Kluwer Medknow Taking a closer glance at the progressively increasing research publications in anaesthesiology from our nation during the last one decade in general and the last 2 years in particular, one may wonder whether it is a factual academic progress with rekindled and rejuvenated interest or just a sheer publication pressure imposed indirectly by the medical education regulatory authorities![1,2]
SukhminderJit Singh Bajwa, MadhuriS Kurdi, JagadishG Sutagatti, SukhwinderK Bajwa, and KaushicA Theerth
Medknow
Background and Aims: Appropriate volume assessment and fluid management can prevent maternal deaths in the severely pre-eclamptic (SPE) parturients. We planned a systematic review and meta-analysis (MA) to evaluate the role and ability of point-of-care ultrasound (POCUS) in the assessment of volume status and early detection of lung oedema in an SPE parturient. Methods: An e-literature search was done from several databases. Data were extracted under five domains including POCUS-derived parameters like echo comet score (ECS), lung ultrasound (LUS) scores, B-patterns, optic nerve sheath diameter (ONSD), E/e' ratio, presence of pleural effusion, pulmonary interstitial syndrome and pulmonary congestion. The risk of bias was assessed. Extracted data were analysed using MetaXL and Revman 5.3. Heterogeneity in the studies was evaluated using the Cochrane Q test and I2 statistics. Funnel plots were used for the assessment of publication bias. Results: Seven prospective studies including 574 parturients (including 396 pre-eclamptics) were selected. POCUS included lung, optic nerve, cardiac and thoracic US. In two studies, the ECS and LUS scores pre-delivery were higher in pre-eclamptics. Two studies found a mean ONSD of 5–5.84 mm before delivery. MA revealed a significantly lower mean ECS score at post-delivery than pre-delivery, and the summary prevalence of B-pattern and pleural effusion among SPE parturients was found to be 0.28 (0.03–0.84) and 0.1 (0–0.2), respectively. A good correlation was observed between B-line patterns and diastolic dysfunction (increased E/e' ratio), LUS score and thoracic fluid content, ONSD and ECS in individual studies. Conclusion: POCUS parameters can be useful as early markers of fluid status and serve as useful tools in the precise clinical management of pre-eclampsia.
VithalK Dhulkhed, ThrivikramaP Tantry, and MadhuriS Kurdi
Medknow
© 2021 Indian Journal of Anaesthesia | Published by Wolters Kluwer Medknow For the advancement of science, it is essential to identify and correct errors that occur in the process of investigation. It is not surprising to know that a significant number of articles even in top-ranking journals continue to have errors in the study design, methodology and statistics.[1] It is interesting to note that in its early years, the original articles submitted for publication to the Indian Journal of Anaesthesia (IJA) lacked sufficient details of data analysis except for a mention of the “mean” and “P value <0.05”. However, over the years, there has been a significant improvement in their quality.[2-12] The research process has undergone continual evolution with the proper application of sound research ethics, study methodology, ways of interpretation of observations and presentation.
Naveen Malhotra, SukhminderJit Singh Bajwa, Muralidhar Joshi, Lalit Mehdiratta, and Madhuri Kurdi
Medknow
The months of April and May 2021 have been extremely challenging for all, especially the anaesthesiologists. In the second wave of COVID‐19 pandemic, very large numbers of patients were infected in a very short span of time. The medical facilities were overburdened with patients leading to scarcity of oxygen, COVID beds, intensive care unit (ICU) facilities, essential drugs and other resources. Besides taking care of COVID and non‐COVID clinical work, the anaesthesiology fraternity during this period was intensely focussed on arranging more and more beds and oxygen for the COVID patients and delivering oxygen from liquid medical oxygen (LMO) tanks, medical gas cylinders, oxygen concentrators or splitting the central oxygen supply (only as dire emergency measures). The clinical, administrative, psychological and social stresses were aptly handled by the anaesthesiologists.
AshwiniH Ramaswamy, MadhuriS Kurdi, LAjay Kumar, SharanabasavaM Choukimath, and AabidhussainA Jangi
Medknow
Background and Aims: The influence of gut microbiota on human behaviour, stress and sleep is currently a novel topic of research. A prospective double-blind randomised trial was planned to find out whether probiotics by alteration of the gut microbiome can allay surgery-related stress and improve sleep. Methods: A total of 160 elective surgical patients were randomised to receive either probiotic or placebo capsule twice daily for four and a half consecutive preoperative days. They were subjected to the Perceived Stress Scale (PSS) questionnaire, a psychomotor vigilance task (PVT) and estimation of salivary alpha-amylase (SAA), a well-known biomarker of stress on the evening of admission and on the evening just before the day of scheduled surgery. Data were analysed using Chi-square test, Student's t-test and Mann–Whitney test. Results: On comparing between the two groups, there was a significant difference in PSS scores, SAA levels and PVT scores after probiotic/placebo therapy. There was a decrease in the PSS scores by 11.38% (P < 0.05) and SAA levels by 11.38% (P < 0.05) and an increase in the PVT scores (12.13%, P < 0.05) following probiotic treatment.There was a mean difference of 52.85 in SAA levels in probiotic group and − 69.32 in placebo group with a definite fall in SAA levels in probiotic group, which showed that these patients had reduced stress levels and improved psychomotor vigilance implying improved sleep. Conclusion: Gut microbiome alteration with probiotics results in lowering of psychological stress and sleep improvement in the preoperative period in surgical patients.
Lalit Mehdiratta, SukhminderJit Singh Bajwa, MadhuriS Kurdi, and PradipKumar Bhattacharya
Medknow
Society of onco-anesthesia and perioperative care (SOAPC) advisory regarding perioperative management of onco-surgeries during COVID-19 pandemic Indian resuscitation council (IRC) suggested guidelines for Comprehensive cardiopulmonary life support (CCLS) for suspected or confirmed coronavirus disease (COVID-19) patient A Danish study found that the average duration of review process was less for COVID category articles (83 8 days for COVID versus 199 7 days for non-COVID) and average length of peer-review reports was also less for COVID category articles (2779 1 words for COVID versus 3015 2 words for non-COVID) The year 2020 was plagued by the coronavirus disease (COVID)-19, which swept the world off its feet [Extracted from the article] Copyright of Indian Journal of Anaesthesia is the property of Wolters Kluwer India Pvt Ltd 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 )
MadhuriS Kurdi and BhagyashriR Hungund
Medknow
Clinical skills are most essential for patient care; however, the assessment of clinical competencies can be challenging and complex.Currently, most traditional assessment methods for postgraduate students (PGS) used in most medical colleges in India (yearly written essay type questions and summative ratings including oral case-based discussions and table viva voce) are summative and try to find out how much the PGS gained knowledge rather than their clinical ability.[1]
SukhminderJit Singh Bajwa, MadhuriS Kurdi, and Lalit Mehdiratta
Medknow
© 2021 Indian Journal of Anaesthesia | Published by Wolters Kluwer Medknow The last three decades have seen a significant and steady progress in the field of anaesthesiology throughout the globe. Anaesthesiology today is a vast speciality in medical science with its sub-specialities ranging from critical care to trauma care, disaster management, pain management and palliative care. The growth of anaesthesiology has been stupendous with ever-developing super-specialities such as cardiac anaesthesia, neuro-anaesthesia, paediatric anaesthesia, regional anaesthesia, onco-anaesthesia, obstetric anaesthesia, geriatric anaesthesia, perioperative medicine and so on. Numerous opportunities and scope come with this growth, for a budding anaesthesiologist to establish his or her professional career. The unawareness of the non-medicos is understandable; however, persons from many streams of the medical fraternity and budding medical students are also not completely aware of the potentials and growth avenues of our speciality.
MadhuriS Kurdi, ManishaD Katikar, Vanita Ahuja, and Ridhima Sharma
Medknow
© 2020 Indian Journal of Anaesthesia | Published by Wolters Kluwer Medknow Women anaesthesiologists in the past have many a times had to deal with negative behaviours of surgeons. A case of a male surgeon telling a lady anaesthesiologist “You should not be working. You should be at home looking after the children” has been reported in a survey. Another instance wherein a female anaesthesiologist was always spoken to by the surgeon via a third person whenever they were working together has also been reported.[1] Well, do such negative attitudes towards women anaesthesia practitioners exist in the operation theatres even today? It is said that gender inequality at work is likely to be still rampant in some parts of the world. Though the professional opportunities are at par for female anaesthesiologists in our nation, they still face challenges.
SukhminderJit Singh Bajwa, Madhuri Kurdi, and Naveen Malhotra
Medknow
workers: A systematic review and meta‐analysis. Clin Infect Dis 2017;65:1934‐42. 30. Phalen RN, Wong WK. Integrity of disposable nitrile exam gloves exposed to simulated movement. J Occup Environ Hyg 2011;8:289‐99. 31. Phalen RN, Le T, Wong WK. Changes in chemical permeation of disposable latex, nitrile and vinyl gloves exposed to simulated movement. J Occup Environ Hyg 2014;11:716‐21. 32. Aerosol Box‐Design [Internet]. Available from: https://sites.google. com/view/aerosolbox/design. [Last cited on 2020 May 01]. 33. Malik JS, Jenner C, Ward PA. Maximising application of the aerosol box in protecting healthcare workers during the covid‐19 pandemic. Anaesthesia 2020;75:974‐75. 34. Au Yong PS, Chen X. Reducing droplet spread during airway manipulation: lessons from the COVID‐19 pandemic in Singapore. Br J Anaesth 2020. doi: 10.1016/j.bja. 2020.04.007 [Epub ahead of print]. 35. Patino Montoya M, Chitilian HV. Extubation barrier drape to minimise droplet spread. Br J Anaesth 2020;S0007‐0912 (20) 30212‐9. doi: 10.1016/j.bja. 2020.03.028. Online ahead of print. 36. Meng L, Qiu H, Wan L, Ai Y, Xue Z, Guo Q, et al. Intubation and ventilation amid the COVID‐19 outbreak Wuhan’s experience. Anesthesiol J Am Soc Anesthesiol 2020;132:1317‐32. 37. Covid 19 Inventory Projection System [Internet]. Available from: https://covid19medinventory.in/appendix/icu. [Last cited on 2020 May 02]. 38. Huang L, Lin G, Tang L, Yu L, Zhou Z. Special attention to nurses’ protection during the COVID‐19 epidemic. Crit Care 2020;24:120. 39. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID‐19 in the New York City Area | Critical Care Medicine | JAMA | JAMA Network [Internet]. Available from: https://jamanetwork.com/journals/jama/ fullarticle/2765184. [Last cited on 2020 May 02]. 40. Tran K, Cimon K, Severn M, Pessoa‐Silva CL, Conly J. Aerosol generating procedures and risk of transmission of acute respiratory infections to healthcare workers: A systematic review. PLoS One 2012;7:e35797. 41. D’Silva DF, McCulloch TJ, Lim JS, Smith SS, Carayannis D. Extubation of patients with COVID‐19. Br J Anaesth Br J Anaesth 2020. doi: 10.1016/j.bja. 2020.03.016 [Epub ahead of print]. 42. Interim CPR guidelines address challenges of providing resuscitation during COVID‐19 pandemic [Internet]. American Heart Association. Available from: https:// newsroom.heart.org/news/interim‐cpr‐guidelines‐ address‐ challenges‐of‐providing‐resuscitation‐during‐covid‐19‐ pandemic. [Last cited on 2020 May 02]. 43. COVID‐19.pdf [Internet]. Available from: https://www.mohfw. gov.in/pdf/1584423700568_COVID19 GuidelinesonDeadbody management.pdf. [Last cited on 2020 May 02]. 44. Shakespeare W. Henry IV, Part I. 1597.
SukhminderJit Singh Bajwa, Madhuri Kurdi, and Konstantinos Stroumpoulis
Medknow
© 2020 Indian Journal of Anaesthesia | Published by Wolters Kluwer Medknow The difficult airway has always posed varying degrees of challenges to the anaesthesiologists. Never before have had these challenges acquired a gigantic stature as they have during the present corona pandemic. This pandemic is necessitating and forcing the anaesthesia fraternity to bring some changes to the established definite algorithm of difficult airway management. Even the teaching manuals and protocols need to be modified to a varied extent taking into consideration the risks posed during normal intubation and ventilation in corona virus disease (COVID) patients. These risks are further amplified if one is confronted with a difficult airway. The Indian Society of Anaesthesiologists (ISA) national has in its recently published Advisory and Position Statement regarding the ‘Corona Virus Disease 2019’ (COVID-19) given important tips on airway management in suspected/ confirmed COVID-19 patients in India.[1,2] The All India Difficult Airway Association (AIDAA) has in this issue of the Indian Journal Of Anaesthesia (IJA) presented its Consensus Guidelines for airway management in the operating room (OR) during the COVID-19 pandemic.[3]