Background: Midazolam is a water soluble benzodiazepine which is frequently administered by intravenous and oral routes in our institution. Its nasal spray has become recently available.Objectives: To compare the efficacy of midazolam administered orally and by intranasal spray, with the specific objective of assessing their efficacy in terms of acceptability to the patients, whether they achieve a satisfactory sedation score, and the overall ease of inducing general anesthesia. Patients and Methods: Sixty healthy children of ASA grade I or II, aged 2-6 years who were undergoing elective surgery of approximately 30 minutes duration, were assigned to receive midazolam premedication in a randomized controlled trial. They were divided into 2 groups of 30 patients each. Group I: 30 patients received midazolam orally (parenteral solution mixed in honey). Group II: 30 patients received a commercially available midazolam nasal spray.Results: The study shows that children better accepted the drug when administered orally than when administered intranasally, although satisfactory sedation scores at 10 and 20 minutes were better in the nasal spray group than in the oral group [i.e., 6 (20%) vs. 0 (0%) at 10 min and 16 (53.3%) vs.13 (43.3%), respectively]. Satisfactory ease of induction scores [24 (80%) vs. 13 (43.3%)], recovery times [11.63±4.19 minutes vs. 25.20±9.36 minutes], and post-anesthesia recovery scores were better in the nasal spray group (group II) than in the oral group (group I).Conclusions: On the basis of our study, we conclude that nasal midazolam spray is acceptable and is a good alternative to oral midazolam as premedication in the pediatric population.

Deformation of every spray into a projective spray can be done using a volume form on a manifold. The Riemann curvature of a projective spray is called the projective Riemmann curvature. In this paper, we present a global rigidity result for projectively PR-flat sprays that have vanishing Douglas curvature. Then we study and characterize projectively PR-flat Randers metrics of Douglas curvature‎.

In this paper a comprehensive review of flow visualization techniques used for the analysis of spray characteristics is presented and an experimental demonstration of different lighting techniques has been made. Still photographs of sprays from an airblast atomizer and a swirl atomizer are taken under backlighting, slit lighting, incident lighting (front flash) and a new method of capturing scattered light image at 1200 to the incident light is introduced in the present work. Photographs taken by these methods are shown to be useful for deriving useful observations such as jet breakup phenomenon, the internal details and the external appearance of the spray. It is demonstrated that the information obtainable from each technique is different and that a combination of different techniques may be necessary for proper diagnosis. The article also includes a discussion on the jet breakup phenomenon as observed in the photographs and in addition a new concept of shear formation of smaller droplets from the surface of a liquid jet by the co-flowing air stream in an airblast atomizer has been proposed.

Background: Respiratory distress syndrome (RDS) is a major cause of mortality among premature neonates. The present study was conducted to find out whether early nasal CPAP therapy could eliminate the need for mechanical ventilation in premature neonates with RDS.Materials and methods: For this clinical trial, premature neonates with RDS during the first 6 hours following the delivery were assigned in either case or control group. Case group received early treatment with nasal CPAP, however, standard treatments were applied for controls based on arterial blood gas analysis.Results: Totally, 25 cases and 22 controls with the mean gestational age of 31.3±2.6 weeks and weight of 1621±540 gr. Totally, 68% of controls versus 40.9% of cases died (p=0.06). However, 80% of controls and 36.4% of cases required mechanical ventilation (p=0.006) that lasted averagely 2.9±2.6 days for controls and 0.68±1.3 days for cases (p=0.0009). Surfactant was injected in 48% of controls and 9.1% of cases (p=0.009). Finally, pneumothorax occurrence, oxygen therapy, and duration of hospitalization in NICU did not significantly differ between groups.Conclusions: Early therapy with nasal CPAP could eliminate the need for mechanical ventilation, and surfactant in premature neonates with RDS. Thus, application of nasal CPAP in centers lack NICU and respirator is strongly suggested.