Publications by authors named "Kulbhushan Saini"

Article Synopsis
  • Airway management is crucial in anesthesia, especially for emergency surgeries where quick intubation is necessary.
  • A study compared the effectiveness of video laryngoscopes against traditional Macintosh blades for first-attempt intubation success in emergency situations.
  • Results showed that the video laryngoscope significantly improved the success rate and visualisation of the glottis during intubation attempts.
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Article Synopsis
  • - This study investigates corneal neurotization (CN), a new surgical method to restore healthy nerve function to the cornea affected by neurotrophic keratopathy (NK), which arises from lost corneal innervation.
  • - Existing treatments mainly focus on preventing damage to the cornea rather than treating the root cause of sensation loss, which makes CN a significant advancement in the field.
  • - The review discusses current research, including clinical studies and case reports, assessing the effectiveness of CN as a potentially permanent solution for NK, aiming to improve ocular surface health.
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Article Synopsis
  • A seven-year-old patient with Sturge-Weber Syndrome and Transposition of the Great Arteries presented with eye issues including retinal detachment and optic disc edema, alongside systemic symptoms like cyanosis and clubbed fingers.
  • Following cardiac surgeries aimed at improving oxygenation, the patient's ocular symptoms significantly improved, demonstrating the connection between heart health and eye conditions.
  • This case underscores how complex vascular issues in conditions like Sturge-Weber Syndrome can affect both ocular and systemic health in children.
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Background: Total anomalous pulmonary venous connection (TAPVC) to left superior vena cava (LSVC) is an extremely rare congenital heart disease, and its surgical management is very challenging.

Case Summary: We report one such case of a 5-year-old south Asian male with double outlet right ventricle and unbalanced atrioventricular canal defect, where all the pulmonary veins were found opening into LSVC, which was then opening into the left side of the common atrium. Intraoperatively, the LSVC was transected just below the left internal jugular vein and left subclavian vein junction and left-sided bidirectional Glenn shunt done using 8 mm Dacron tube graft.

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Background And Aims: Post-discharge nausea and vomiting (PDNV) is a pertinent problem in patients undergoing ambulatory surgery. The objective of this study was to assess the efficacy of the novel drug olanzapine, which has proved its efficiency in patients undergoing highly emetogenic chemotherapy for PDNV prevention.

Methods: This randomised controlled trial recruited 106 adult patients (18-65 years) undergoing highly emetogenic daycare surgeries with propofol-based general anaesthesia (GA).

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Background: efficacy of therapeutic cholecalciferol supplementation for severe COVID-19 is sparingly studied.

Objective: effect of single high-dose cholecalciferol supplementation on sequential organ failure assessment (SOFA) score in moderate-to-severe COVID-19.

Methods: participants with moderate to severe COVID-19 with PaO2/FiO2 ratio < 200 were randomized to 0.

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Objective: To evaluate the efficacy of corneal neurotisation using sural nerve graft coaptation of the contralateral supratrochlear nerve in unilateral neurotrophic keratopathy and corneal anesthesia. Corneal neuralization has emerged as a potential option in the treatment of neurotropic keratopathy, however not free from the predicament. We evaluated the long-term outcome of corneal neurotisation in the treatment of unresponsive unilateral neurotropic keratopathy using surgical variations to mimic and expedient the surgical procedure.

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Background: Transurethral resection of bladder tumors (TURBT) surgeries requires post-resection catheterization for continuous irrigation of the bladder. This indwelling catheter is associated with distressing catheter-related bladder discomfort (CRBD) and increases postoperative pain and agitation.

Objectives: To prove the hypothesis that transurethral 100 mg lidocaine irrigation at the end of TURBT can reduce the frequency of moderate-to-severe postoperative CRBD.

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Background & Objectives: The high mortality associated with the thrombotic events in hospitalized COVID-19 patients resulted in the usage of anticoagulants in varying doses. Whether high-dose anticoagulants have led to better outcomes or higher incidence of clinically significant bleeding events is debatable. Thus, this study was conducted to find the incidence of clinically significant bleeding events in moderate-to-severe COVID-19 ARDS (acute respiratory distress syndrome) patients on therapeutic anticoagulation and their outcomes.

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Purpose: The purpose of the study is to evaluate the safety and efficacy of adjunctive use of mitomycin-C (MMC) using two different concentrations 0.2 mg/ml and 0.4 mg/ml for lacrimal duct probing to treat the nasolacrimal duct obstruction (NLDO) in adults.

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Variations in the alveolar plateau phase of the capnogram are often confused with spontaneous breathing efforts in an intubated patient. The oscillations in the capnogram due to a large ascending thoracic aneurysm are a separate entity from cardiogenic oscillations, and can be an indicator of underlying bronchial or lung compression.

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Congenital complete heart block (CCHB) has an incidence of one in 20,000 live births and carries a 20% risk of mortality. The hemodynamic instability due to bradycardia and asystole due to the increasing metabolic demands can be avoided by appropriate antenatal planning, timely delivery and initiation of medical treatment and early pacemaker insertion. In this report, we discuss the anaesthetic challenges of permanent epicardial pacemaker insertion with good outcomes in a 32-week gestational age 1380 grams neonate within a few hours of birth.

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Article Synopsis
  • Recent trials suggest high-dose dexamethasone (HDD) and tocilizumab (TCZ) may help treat moderate to severe COVID-19 with ARDS, but no direct comparison had been made until this study.
  • Patients with worsening conditions were randomly assigned to receive either HDD or TCZ along with standard care, with the main goal of measuring ventilator-free days within 28 days.
  • Results showed HDD led to significantly fewer ventilator-free days and higher mortality rates, along with more secondary infections, leading to a recommendation against its use in favor of TCZ, which proved to be safer and more effective.
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Background Survivors of COVID-19 pneumonia may have residual lung injury and poor physical and mental health even after discharge. We hypothesized that COVID-19 severe acute respiratory distress syndrome (ARDS) patients needing mechanical ventilation may be at a greater risk of deterioration in pulmonary function, mental health, and quality of life (QOL). This study analyses the differences in pulmonary function, mental health, and QOL after recovery, in patients having received non-invasive oxygen therapy versus invasive mechanical ventilation during ICU stay.

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COVID-19 pandemic is an emerging, rapidly evolving public health emergency where a nation's health-care system can face a marked surge in demand for intensive care unit (ICU) beds and organ support. In regions with insufficient medical resources, it may further aggravate the existing shortage, limiting an ICU's ability to provide the normal standard of care. It can present ethically or legally demanding questions about how to prioritize the allocation of life-saving medical resources.

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Ventricular septal defects (VSD) are the most common congenital cardiac defect. Patients with large VSDs present early due to an increase in the volume load on the left ventricle and pressure load on the right ventricle. Few of them present late even without surgical intervention, due to partial restriction of perimembranous (PM) VSD, either by the septal leaflet of the tricuspid valve or by aortic valve cusp prolapse into the VSD.

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Objective: Regional analgesia continues to evolve with the introduction of ultrasound-guided fascial plane blocks. Erector spinae plane block (ESPB) is a novel technique gaining recent acceptability as a perioperative modality of analgesia in various thoracic and abdominal surgeries. However, literature on the use of ESPB in pediatric cardiac surgery is limited.

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Objective: The aim of this study was to compare the relative efficacy of ultrasound-guided serratus anterior plane block (SAPB), pectoral nerves (Pecs) II block, and intercostal nerve block (ICNB) for the management of post-thoracotomy pain in pediatric cardiac surgery.

Design: A prospective, randomized, single-blind, comparative study.

Setting: Single-institution tertiary referral cardiac center.

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Background: Preoperative fasting in children can cause anxiety, which may ultimately lead to postoperative emergence delirium. However, no data are available whether duration of preoperative fasting correlates with postoperative emergence delirium.

Aims: The aim of this study was to identify if there is any correlation between the duration of preoperative fasting and emergence delirium in children undergoing ophthalmic examination under anesthesia.

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