The Indian Society of Critical Care Medicine Position Statement on the Management of Sepsis in Resource-limited Settings.

Unlabelled: Sepsis poses a significant global health challenge in low- and middle-income countries (LMICs). Several aspects of sepsis management recommended in international guidelines are often difficult or impossible to implement in resource-limited settings (RLS) due to issues related to cost, infrastructure, or lack of trained healthcare workers. The Indian Society of Critical Care Medicine (ISCCM) drafted a position statement for the management of sepsis in RLS focusing on India, facilitated by a task force of 18 intensivists using a Delphi process, to achieve consensus on various aspects of sepsis management which are challenging to implement in RLS.

The U- advancement Burrow's Flap in Persistent Tracheocutaneous Fistula. ~ Case Report.

Persistent tracheo-cutaneous fistulae necessitate a closure with pedicled or free flaps. The modality adopted is to reconstitute the anterior tracheal wall without compromising the tracheal lumen. We have developed the lateral U advancement Burrow's flap over the strap muscles and tracheal lateral fibrous flaps, to repair a large trachea-cutaneous fistula.

Adverse Events during Intrahospital Transport of Critically Ill Patients: A Multicenter, Prospective, Observational Study (I-TOUCH Study).

Background: Critically ill patients are frequently transported to various locations within the hospital for diagnostic and therapeutic purposes, which increases the risk of adverse events (AEs). This multicenter prospective observational study was undertaken to determine the incidence of AEs related to intrahospital transport, their severity, and their effects on patient outcomes.

Patients And Methods: We included consecutive unstable critically ill patients requiring intrahospital transport, across 15 Indian tertiary care centers over 5 months (October 11, 2022-February 20, 2023).

Glial Heterotopia of the Middle Ear: First Case in Indian Literature.

A 66-years-old female presented with impaired hearing of two-year duration and a recent ear discharge. High-resolution computed tomography and intra-operative findings showed a mass lesion in the right middle ear cavity that was unconnected with the brain. A histopathological diagnosis of glial heterotopia was made and an etiopathogenic hypothesis was analysed.

Comparative Evaluation of Apnoea Graph and Polysomnography in Sleep Disordered Breathing in an Urban Indian Population.

Apnoea graph (AG) system is a new technology designed for evaluation of Sleep Disordered Breathing and more importantly the site of obstruction in Obstructive Sleep Apnoea (OSA). Apnoea Graph being a new modality of assessment needs to be evaluated with the time tested gold standard PolySomnoGraphy (PSG) along with its unique capability of establishing the level of obstruction. A prospective study of 30 patients of snoring and/or suspected for OSA was conducted in Sir Ganga Ram Hospital, New Delhi with recordings of both overnight sleep study and apnoea graph performed separately for each patient.

A Retrospective Study of Ultrasound-Guided Pericapsular Nerve Group Block With Dexamethasone: An Excellent Option for Early Mobility Following Total Hip Replacement Surgery.

Background Severe postoperative pain and immobility increase the length of hospital stay and immobility-related life-threatening complications after total hip replacement (THR). Pericapsular nerve group (PENG) block is a recent addition to pain management of neck of femur (NoF) fracture, the use of which has been incorporated into THR as alternative analgesia or as an adjunct with other regional analgesia techniques. The present study primarily aims to assess postoperative mobility.

Therapeutic Modalities in Head-Neck Neoplasia and Prognostication: A Review.

Neoplasia of the head and the neck necessitates intervention, surgical or otherwise, as the site and stage of the pathology may dictate. The various therapeutic modalities employed and prognosis has been reviewed.

SARS-CoV-19-associated Rhino-orbital and cerebral mucormycosis: clinical and radiological presentations.

We describe presenting clinical and imaging manifestations of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-associated Rhino-oculo-cerebral mucormycosis (ROCM) in a hospital setting during the second wave of SARS-CoV-2 pandemic in India. Data on the presenting manifestations were collected from 1 March to 31 May 2021. Associations between clinical and imaging findings were explored, specifically: (1) the presence or absence of orbital pain and infiltration of a superior orbital fissure on imaging; (2) the presence of unilateral facial nerve palsy and pterygopalatine fossa infiltration and geniculate ganglion signal on contrast magnetic resonance imaging, and (3) vision loss and optic nerve findings on imaging.

Laser-Assisted Sialolithotripsy: A Correlation of Objective and Subjective Outcomes.

Objective: To analyze the long-term symptomatic results of laser-assisted sialolithotripsy (LAS) in cases of obstructive sialolithiasis and correlate with objective criteria using diagnostic sialendoscopy (DS) as a method of examination.

Methods: This is a retrospective study comprising 50 consecutive patients who underwent holmium-YAG LAS and completed follow-up of at least 6 months. Symptom scoring and endoscopic scoring were done at 6 weeks and 6 months intervals for further study purposes.

Expert Consensus Statements on the Use of Corticosteroids in Non-severe COVID-19.

Introduction: There is strong evidence for the use of corticosteroid in the management of severe coronavirus disease-2019 (COVID-19). However, there is still uncertainty about the timing of corticosteroids. We undertook a modified Delphi study to develop expert consensus statements on the early identification of a subset of patients from non-severe COVID-19 who may benefit from using corticosteroids.

Predictors of Anastomotic Complications After Resection and Anastomosis for Tracheal Stenosis.

Resection and anastomosis is an effective option for the management of complex tracheal stenosis, however, it's not without the complications. This study aims at evaluating various factors predicting anastomotic complications after trachea resection and anastomosis. This is a retrospective analysis of database from a dedicated thoracic surgical unit in New Delhi, India over 7 years.

The Transport Medicine Society Consensus Guidelines for the Transport of Suspected or Confirmed COVID-19 Patients.

Unlabelled: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and has been declared as a pandemic. COVID-19 patients may require transport for diagnostic or therapeutic purposes intra- or interhospital or transport from an outside hospital to a healthcare facility. Transport of critically ill or infectious patients is always challenging and involves the integration of various tasks and manpower.

Systemic Involvement of Novel Coronavirus (COVID-19): A Review of Literature.

Unlabelled: COVID-19 outbreak has caused a pandemonium in modern world. As the virus has spread its tentacles across nations, territories, and continents, the civilized society has been compelled to face an unprecedented situation, never experienced before during peacetime. We are being introduced to an ever-growing new terminologies: "social distancing," "lockdown," "stay safe," "key workers," "self-quarantine," "work-from-home," and so on.

Parotid or carotid? Misled by site.

We present an interesting scenario where a 64 years old male presented with a long standing painless, infra-auricular swelling, which had progressively increased in size. Based on the site, the clinical impression was of a salivary gland lesion and FNAC was performed. The smears were unusually cellular and had necrotic background.

Eosinophilic Angiocentric Fibrosis of Sinonasal Region: A Rare & Under Reported Entity.

Eosinophilic angiocentric fibrosis is a rare pathology of the sinonasal tract and the upper respiratory system characterised by fibrosis with poorly understood pathogenesis. A 47-year-old male presented with a swelling over the dorsum of the nose. The possibility of fungal granuloma was being suggested on Magnetic Resonance Imaging (MRI).

Laryngeal cryptococcus: a rare cause of hoarseness in renal allograft recipient.

Cryptococcosis commonly involves central nervous system and lungs in organ transplant recipients. Isolated laryngeal infection is extremely rare. We report a rare case of cryptococcus in a renal allograft recipient that clinically presented with hoarseness of voice and mimicked laryngeal carcinoma on examination.

Prospective evaluation of the quality of life of oral tongue cancer patients before and after the treatment.

Background: This prospective study was to evaluate the changes in quality of life (QOL) after 12 months post treatment from their pre-treatment levels, using specific questionnaires of well-known acceptability, responsiveness, and validity, with special emphasis on domains such as chewing, swallowing, speech, psychological aspects (mood and anxiety) and pain.

Methods: This prospective analytical study included a total of 72 patients affected by oral tongue cancer (T1-2N0M0) who underwent treatment [wide local excision with selective + radiotherapy (RT)] from 2009 to 2012 at the Department of Oncosurgery and Otorhinolaryngology-Head and Neck Surgery, Sir Ganga Ram Hospital, New Delhi.

Results: A total of 39 (54.

Malignant Transformation of Vagal Nerve Schwannoma in to Angiosarcoma: A Rare Event.

Schwannomas are benign, rare peripheral nerve sheath tumors that occur in the head and neck region. Some physicians opt to closely observe cases of schwannoma of the neck on an outpatient basis rather than to perform radical surgery. However, there is a possibility, albeit rare, of malignant transformation of a benign schwannoma.

Angiosarcoma Developing in a Vagal Schwannoma: A Rare Case Report.

Angiosarcoma arising in a schwannoma is extremely rare with only fourteen cases having been reported in the literature to the best of our knowledge. Amongst these fourteen, only five cases developed from vagal schwannoma. We describe a case of epithelioid angiosarcoma arising in a long standing vagal schwannoma in a 41 years male patient.

Primary diffuse large B cell lymphoma of the base of tongue: a rare entity.

Primary lymphomas of the oral cavity are uncommon and of the tongue even rarer. It is more common in the masticatory mucosa than the lingual and buccal mucosa. We describe a 63 year old male who presented with dysphagia & change in voice.

Navigation in endoscopic sinus surgery: the first Indian experience.

Although the use of image guidance surgery (IGS) is standard practice in developed countries, it has not been in use in Indian Otolaryngology ever since its clinical inception in 1994. Some clinically interesting applications, relevant indications, practical tips and results in the Indian context are presented. Usage technique and data presentation.

Chemical stabilization of a Delta9-tetrahydrocannabinol prodrug in polymeric matrix systems produced by a hot-melt method: role of microenvironment pH.

This research was conducted in order to fabricate stable polyethylene oxide (PEO)-based transmucosal systems of a Delta(9)-tetrahydrocannabinol (THC) prodrug, a hemisuccinate ester, using a hot-melt method. Since Delta(9)-tetrahydrocannabinol-hemisuccinate (THC-HS) was heat labile, a series of processing aids were evaluated in order to facilitate hot-melt production at lower temperatures, thereby reducing THC-HS degradation. The stability of THC-HS was influenced both by the processing conditions such as heating time and temperature, and the postprocessing storage conditions.