Frailty describes a state or syndrome of reduced physical, physiologic, and cognitive reserve that increases vulnerability to acute illness. To study the prevalence frailty in critically ill patients find its association with resource utilization short-term intensive care unit (ICU) outcomes.This was prospective observational study. All adult ≥50 years admitted ICU were included assessed by clinical score (CFS). Data collected on demography, coexisting illness, CFS, Acute Physiology Chronic...

Background and aims: Sustained low-efficiency dialysis (SLED) is a cost-effective alternative to continuous renal replacement therapy (CRRT) in critically ill acute kidney injury (AKI) patients, addition intermittent hemodialysis (IHD) as mode of (RRT) such patients. This single-center, prospective, observational study aimed assess the short-term outcomes SLED IHD Methodology: Adult (>18 years) patients with AKI requiring were included from different ICUs tertiary care center. Patients...

Summary Background: The aim of our study was to determine the optimal dose propofol preceded by fentanyl for successful tracheal intubation and see its effectiveness in blunting pressor response children aged 3–10 years. Methods: This prospective, double blind, randomized conducted on 60 ASA grade I II children, between 3 10 years undergoing elective surgery who were divided into three groups 20 each. received different doses (group I, 2.5 mg·kg −1 ; group II, 3.0 III, 3.5 ) a fixed (3.0 μ...

Peripheral blood smear (PBS) changes in coronavirus disease 2019 (COVID-19) are diverse and have been reported the literature form of case series with relatively smaller sample sizes a handful studies showing association between PBS clinical severity. This study aims to highlight numerical morphological peripheral COVID-19 patients compare same intensive care unit (ICU) non-ICU settings as well severity outcome. The included 80 positive (41 ICU 39 non-ICU) 32 negative patients. Complete...

Awareness of the presence thyroid function abnormalities in patients with molar pregnancy is important for its prompt diagnosis and management. We report development storm immediate post-operative period a 25-year-old female who underwent evacuation her under saddle spinal block after being controlled thyrotoxicosis combination antithyroid drugs, iodine, steroids adrenergic blocking agents. advocate use esmolol infusions up to maximum dose 200 μg/kg/min haemodynamic management patient....

Carcinoid tumours pose a great challenge to anaesthesiologist, especially if carcinoid syndrome is present. We report peri-operative management of patient with who underwent upper lobectomy. Pre-operative optimisation for 10 days before surgery injection octreotide and administration on the day as per guidelines was followed (North American Neuroendocrine Tumour Society guidelines). Our main goals were prevent mediator release, avoidance triggering factors crisis. During tumour handling...

Giant paraesophageal hernia is an uncommon morbid disorder which may present a risk of catastrophic complications and should be repaired electively as soon possible. Laparoscopic fundoplication the mainstay surgical management this due to several advantages such lower post-operative morbidity pain. We report case 70-year-old patient with giant hernia, who developed subcutaneous emphysema pneumothorax during laparoscopic fundoplication. Early diagnosis was possible by close clinical...

Background: Accurate assessment of intravascular volume status is a vital aspect management intensive care unit (ICU) patients. Inferior vena cava (IVC) diameter and IVC collapsibility index have surfaced as promising methods to accurately predict hypovolemia. But no such study has evaluated it’s their utility in postoperative patients.
 Methods: The aimed assess the correlation between ultrasound guided (IVC CI) CVP for Hundred spontaneously breathing patients receiving our surgical...

Abstract Background and Aims: Several methods are in use for LMA ProSeal™ size selection pediatric patients. Weight-based method is most commonly used. Pinna size–based a promising new technique accurate selection. Material Methods: A total of 146 children aged between 6 months 12 years undergoing surgery under general were included. They randomized into either pinna-based group (group X) or weight-based Y). Both groups compared placement laryngeal mask airway (PLMA), ease insertion, number...

Sir, A 66-year-old male patient with bronchial carcinoid of left upper lobe lung was scheduled for lobectomy. Standard monitors were attached and patients trachea intubated a 35 Fr sided double lumen tube. Left internal jugular vein (IJV) cannulated 7 20 cm triple catheter using anatomical landmark based technique in single attempt central approach fixed at 13 cm. Central venous pressure (CVP) trace normal back flow present all the ports. The CVP began to dampen after thoracotomy retraction...

Sir, A 4-year-old, 120 cm, 12 kg, male was scheduled for orchidopexy. He mentally retarded, and his milestones were delayed. on treatment focal complex partial myoclonic seizures from the age of 3 years. Diffuse hypoplasia corpus callosum magnetic resonance imaging, nonconvulsive status epilepticus electroencephalography; patent foramen ovale echocardiography spina bifida at L4-5 X-ray spine reported. The child had characteristic facies [Figure 1]. Molecular genetic studies chromosome 15...

INTRODUCTION Congenital epulis is a benign soft-tissue lesion of the alveolar mucosa. It may be sessile or pedunculated and vary in size from several millimetres to few centimetres.[12] Surgical excision treatment choice. The most important aspect pre-anaesthetic evaluation assessment for difficult airway. Literature on anaesthetic management neonates with congenital limited isolated case reports.[34] We discuss development post-intubation tension pneumothorax pneumoperitoneum neonate an...

Background: Laryngoscopy and intubation has adverse effects like tachycardia, hypertension, myocardial ischemia cerebral hemorrhage. There are many studies on various pharmacological agents to attenuate pressor response. Aim of the study was compare efficacy safety oral clonidine versus pregabalin premedication stress response in patients undergoing elective surgery. Methods: 106 American Society Anesthesiologist (ASA) class I, aged between 18-60 years either sex scheduled for surgery were...

Background: Trauma is an injury to living tissue from external source. The severity of traumatic injuries plays a crucial role in the determination mortality patients with trauma, thus proper understanding trauma very important for improving care. Several scoring systems are available objective, initial assessment help treatment strategy. Aim study was compare Emergency Score (EMTRAS) Rapid Medicine (REMS) prediction early adult patients. Methods: Study conducted 100 either sex, age 18 years...

Drug induced vasculitis is a potentially life and limb threatening complication which can be precipitated by intake of virtually any pharmaceutical agent. It diagnosis exclusion as definitive diagnostic laboratory criteria have not been defined. Withdrawal the offending agent therapy but use antithrombotic, vasodilatory anti-inflammatory agents has proven to beneficial. We report case dry gangrene bilateral lower limbs digits upper due DIV secondary chloramphenicol in child diagnosed with...

Background: Pain is associated with increased sympathetic activity leads to tachycardia, elevated blood pressure and myocardial insults so pain control necessary during the surgery in postoperative period. Aim of study was effect intravenous dexamethasone on duration analgesia provided by supraclavicular block (SCB) for upper limb surgery.
 Methods: 75 patients, age between 18 70 years either sex, ASA class I II, who were undergoing randomized into three groups 25 patients each computer...

Tetanus, also known as lockjaw, is an infection characterized by muscle spasms. In the most common type, spasms begin in jaw and then progress to rest of body. These usually last a few minutes each time occur frequently for three four weeks. Tetanus disease caused toxin produced ubiquitous bacterium, Clostridium tetani. C tetani can be acquired through surgery, intravenous drug abuse, neonate's umbilicus, bites, burns, body piercing, puncture wounds, ear infections. This organism enter any...

Comments&Controversies More on the travesty of pre-authorizationWe were delighted to read Dr. Nasrallah's coruscating editorial about deceptive, unethical, and clinically harmful practice insurance companies requiring pre-authorization before granting coverage psychotropic medications that are not their short list inexpensive alternatives ("Pre-authorization is illegal, adversely disrupts patient care."From Editor, Current Psychiatry.April 2020, p. 5, 10-11).Obtaining time-consuming for busy...