Activity

  • Thaysen Barrett posted an update 1 day, 4 hours ago

    Tracheobronchial foreign bodies are common in pediatric patients, but also seen in adult patients. Most of these patients present with history of foreign body inhalation, or with the symptoms like cough, respiratory distress. In this paper, we would like to report an incidental finding of a tablet in tracheobronchial tree during double lumen tube placement with fiberoptic bronchoscopy in a middle-aged patient scheduled for right lung decortication for hemothorax. We also learned that delay in removing the tablet would make the removal of foreign body complicated. The patient did not report any history of aspiration or have any signs and symptoms consistent with aspiration. We also discussed the difficult in diagnosing foreign-body aspiration in adults with nonspecific symptoms.Idiopathic intracranial hypertension (IIH) typically affects obese young women. Treatment is mainly medical, but some cases require surgery; ventriculoperitoneal (VPS) or lumboperitoneal shunts (LPS) being the most common procedures. Although bariatric surgery is not the first-line surgical treatment, it can be useful in refractory cases and allows treating the major underlying risk factor and its comorbidities. Laparoscopic bariatric surgery is the gold standard; however, literature in patients with shunts is scarce. In the present study, we report the case of a morbidly obese female with IIH treated with an LPS and with refractory headache, scheduled for laparoscopic Roux-en-Y gastric bypass. LPS position was checked before surgery (abdominal X-ray) and during pneumoperitoneum was clamped. Anesthetic management was guided to minimize increases in intracranial pressure (ICP). Surgery and anesthesia were uneventful. Three months later, headaches disappeared and analgesics were discontinued. In conclusion, laparoscopic bariatric surgery may be an option for IIH. It is safe in patients with LPS, although concerns should be taken into account (avoid any damage to the shunt, limit digestive tract contents spillage, and strict vigilance for early detection of intracranial hypertension signs). Although valve system could prevent pressure complications, the catheter can be clamped to avoid retrograde insufflation of CO2 or digestive tract content.Humanity is witnessing an unprecedented tsunami of corona virus disease 2019 (COVID-19) patients. Till date, India houses 10,453 confirmed COVID-19 patients with a death toll of 358 nationwide and the number is steadily rising with each passing day. The capital city of Delhi, harbouring 1510 patients, has the dubious distinction of being the second largest hotspot for COVID positive patients in India, second only to the state of Maharashtra. Being immuno-compromised, cancer patients are first more susceptible to catch this virus and secondly may witness a more devastating course. Having cancer is a bigger risk factor for contracting COVID-19 than even old age. “Death due to untreated cancer is a much bigger reality than death due to COVID-19,” is one perspective that advocates continuation of cancer therapy in corona times albeit by converting cancer hospitals into virtual corona-free fortresses with several tiers of barriers against corona. The immediate, short and long term implications of the corona pandemic and a nationwide lockdown to curtail it, on cancer patients and their caregivers is discussed at length here tempered with experience from the largest tertiary care oncology setup of Northern India. Rigorous literature review based on Medline, Google scholar, Embase, Cochrane and Scopus database search was utilized.The outbreak of the novel COVID-19, which began silently in Wuhan City, China, has now taken the form of a pandemic, with its claws spreading rapidly in many countries, with new and new cases emerging rapidly. The COVID-19-associated CoV is a beta coronavirus, which spreads at such a deadly rate that the World Health Organization (WHO) has to declare it a Public Health Emergency of International Concern (PHEIC). The objective of the narrative review is to describe what is COVID-19-related coronavirus (CoV), its structure and particle size, potential transmission routes, the risk of infection in patients undergoing blood transfusion or in patients with diabetes and cancer, and recommendations to prevent its spread in office settings, travel / recreation settings, residential and health facilities. This paper also discusses several groundbreaking approaches that are used to counter COVID-19. With this narrative review, we hope to raise awareness of the usual and unusual pathways of transmission and prevent the spread of this pandemic disease.

    Several studies have attempted to estimate the approximate distance from the skin-to-epidural space using different imaging modalities (computed tomography [CT], ultrasound, and magnetic resonance imaging [MRI]) and direct needle measurements. The objective of our study was to compare the distance from the skin to the epidural space (SED) at multiple levels, focusing on T

    , T

    , and L

    using MRI.

    After institutional review board (IRB) approval, sagittal T2-weighted MRI images of the spine of 108 children in the age group ranging from 3 months to 8 years undergoing radiological evaluation in the supine position at our institution were analyzed. The SED at T

    and T

    levels (straight and inclined) and SED at L

    (straight) were determined and compared using repeated-measures ANOVA and paired

    -tests with a Bonferroni correction for 10 pairwise comparisons (

    < 0.005 was considered statistically significant).

    The average SED (measured straight and inclined) was 18.2 mm and 21.6 mm at T

    ; 18.3 mm and 20.5 mm at T

    ; and 21.8 mm (straight) at L

    . The repeated-measures ANOVA F-test indicated significant variability in SED (

    < 0.001) among the 5 measurements obtained. At the

    < 0.005 significance level, corrected for multiple comparisons, the SED (straight) at T

    straight was shorter than the other measured distances.

    The distance from the skin to the epidural space is not constant at various vertebral levels. At the levels measured, it was greatest at the lumbar level and at least at the thoracic level of T

    . A single predictive formula was not applicable for calculating the approximate SED at all vertebral levels.

    The distance from the skin to the epidural space is not constant at various vertebral levels. At the levels measured, it was greatest at the lumbar level and at least at the thoracic level of T9-10. this website A single predictive formula was not applicable for calculating the approximate SED at all vertebral levels.