Background: T his study was done to compare effects of intranasal midazolam and with ketamine for premedication children aged 1-12 yrs undergoing intermediate major surgeries. Aims: Midazolam Ketamine have already been used as premedicants in children. Our aim find out advantage combination over by nasal route. Methods: Sixty age group American Society Anesthesiologists (ASA) grade 1 2 were selected. Group A- (0.2 mg/kg), B- (0.15 mg/kg + mg/kg). Both groups received drug intranasally 30 min...

INTRODUCTION Carotid body tumours (CBTs) are extremely rare arising from chemoreceptor cells at bifurcation of carotid artery. Reported incidence is 1-2 per 100,000.[1] Frequently these turn out to be malignant, hence operative intervention the rule. Removal tumour poses several anaesthetic challenges and associated with perioperative morbidity 20-40%.[2] This brief communication highlight management problems encountered during CBT excision. CASE REPORT A 38-year-old female weighing 47 kg...

A 72-year-old male patient with gall bladder perforation and small intestinal obstruction from impacted stone was posted for emergency laparotomy. He had congestive heart failure, severe hypertension at admission history of multiple other coexisting diseases. On admission, he developed pulmonary oedema systolic which controlled by ventilatory support, nitroglycerine furosemide. Preoperative international normalized ratio 2.34 left ventricular ejection fraction only 20%. Because risk...

Achondroplasia is the commonest form of short-limbed dwarfism and occurs in 1:26,000-40,000 live births. This an autosomal dominant disorder with abnormal endochondral ossification whereas periosteal intramembranous are normal. The basic abnormality a disturbance cartilage formation mainly at epiphyseal growth plates base skull. anesthetic management achondroplastic dwarfs challenge to anesthesiologist. Both regional as well general anesthesia have their individual risks consequences. We...

Congenital anomalies pose many challenges during anesthesia due to anatomic and physiological alterations. The inherent complications associated with the disorders necessitate vigilance for providing even seemingly simple surgical intervention. Here, we share our experience of management an infant congenital osteogenesis imperfecta pyloric stenosis pyloromyotomy.

Guillain-Barré Syndrome (GBS) is an autoimmune disorder which can present in acute and chronic forms. It inflammatory demyelinating polyneuropathy. These patients pose potential perioperative risks of autonomic dysfunction respiratory muscle weakness. The current case report shows a 66-year-old female with history fall at home eight days prior to surgery, diagnosed right-sided proximal humerus fracture. patient was GBS hypertension since five years. For GBS, she had Intensive Care Unit (ICU)...

INTRODUCTION Noonan syndrome (NS) is an autosomal dominant disorder with craniofacial, cardiac, skeletal abnormalities, haemorrhagic diathesis, reported incidence of 1 in 1000 to 2500 live births.[1] Various lymphatic abnormalities have been observed these patients including pulmonary and intestinal lymphangiectasia lymphoedema.[2] Craniofacial dysmorphism webbed neck atlantoaxial instability can complicate airway management.[3] The anaesthetic considerations include difficult airway,...

Carotid body tumour (CBT) is an extremely rare, non-chromaffin paraganglioma arising from chemoreceptor cells at the carotid bifurcation. Reported incidence 1-2 per 100,000. Surgical excision of tumour, definitive treatment, poses several anaesthetic challenges and a high perioperative morbidity mortality (20-40%). Very few cases have been reported so far. We report management case CBT with review recent literature on same.

Sir, There is paucity of literature on delivery anesthesia to patients with coexisting sick sinus syndrome and Alzheimer's disease. We recently administered a 79-year-old, 34 kg, 148 cm male patient disease thoracolumbar kyphosis for bilateral inguinal hernia repair. The was known case Sick Sinus had permanent pacemaker implanted 11 years back. He diagnosed have senile dementia 7 back taking oral quetiapine 6.25 mg once day rivastigmine 1.5 twice week. irritable uncooperative. Preoperative...

Sir, Autoimmune disease of the pituitary is rare and poorly understood as a pathologic entity.[1] The purpose reporting this case rarity disease, especially in males, scarce literature on such patients presenting for other than transphenoid surgery autoimmune hypophysitis (AH). An 80 kg, 60-year-old man was scheduled fractured tibia surgery. One year ago, patient had presented with headache, vomiting, delirium, incoherent speech diagnosed to have AH central hypothyroidism hypocortisolism....