The Role of Salivary Lactate Levels in assessing the Severity of Septic Shock.

Background: Sepsis is a major worldwide cause of morbidity and mortality. Hence, rapid and reliable diagnosis is essential. Emergency departments use a standard measure of sepsis, based upon an elevated Lactate level in blood.

Vajra Bhasma, Ayurvedic medicine: a rare and unusual cause of Lyell's syndrome and its successful management.

Toxic epidermolysis necrosis (TEN) or Lyell syndrome is a potentially life-threatening immunological adverse skin disease, which mostly occurs secondary to the intake of an offending drug. It commonly manifests as a widespread exfoliating bullous lesion in skin and mucous membrane mimicking superficial burns and may result in hypovolemic and/or septic shock. Authors report an unusual case of Lyell's syndrome in a 42-year-old woman, secondary to the intake of Ayurveda medicine 'Vajra Bhasma' (Diamond Ash) prescribed by an Ayurveda physician for treatment of her trigeminal neuralgia.

Re-emergence of TIVA in COVID times.

Total intravenous anaesthesia (TIVA) is a technique of general anaesthesia (GA) given via intravenous route exclusively. In perspective of COVID-19, TIVA is far more advantageous than inhalational anaesthesia. It avoids the deleterious effects of immunosuppression and lacks any respiratory irritation, thus providing an edge in the current situation.

Comparative evaluation of dexmedetomidine and clonidine with low dose ropivacaine in cervical epidural anesthesia for modified radical mastectomy: A prospective randomized, double-blind study.

Context: Alpha-2 adrenergic agonists clonidine and dexmedetomidine, are well known to produce analgesia through an opioid independent mechanism. Alpha-2 agonists are used as an adjuvant to local anesthetic agents to extend the duration of spinal, epidural and brachial plexus blocks.

Aims: We compared clonidine and dexmedetomidine as an adjuvant to Ropivacaine in cervical epidural anesthesia (CEA) with respect to onset and duration of sensory block, duration of analgesia and adverse effects.

A retrospective cohort study of perioperative prognostic factors associated with intra-abdominal sepsis.

Context: Intra-abdominal sepsis following laparotomy for acute abdomen remains still a challenging condition. The understanding of various perioperative risk factors by anesthesiologists are crucial in optimum management these patients.

Aims: The objective of this study is to assess the perioperative risk factors, which predicts the outcome of treatment.

A comparative study of hemodynamic changes between prone and supine emergence from anesthesia in lumbar disc surgery.

Background: Supine emergence from anesthesia in patients undergoing lumbar surgery in prone position leads to tachycardia, hypertension, coughing, laryngospasm and loss of monitoring as the patients are rolled back to supine position at the end of surgery. The prone extubation might facilitate a smoother emergence because the patients are not disturbed during emergence and secretions are drained away from patient's airway.

Materials And Methods: The patients were randomly allocated to one of the two groups of 30 each at conclusion of surgery.

A patient with situs inversus totalis presenting for emergency laparoscopic appendectomy: Consideration for safe anesthetic management.

Situs inversus totalis is an uncommon congenital positional anomaly in which orientation of all asymmetric organs in the body are mirror image of normal morphology. The condition if undetected may pose a diagnostic problem of abdominal pathology. We present a case of situs inversus totalis with acute appendicitis in adult female who was previously unaware of her situs anomaly.

Efficacy and safety of dexmedetomidine as an additive to local anesthetics in peribulbar block for cataract surgery.

Background And Objectives: We evaluated the effect of adding dexmedetomidine to lidocaine and bupivacaine for peribulbar block in two different doses. The primary endpoints were the onset and duration of corneal anesthesia, globe akinesia, and duration of analgesia.

Materials And Methods: A randomized controlled clinical trial was conducted on 90 ASA I-II patients scheduled for elective cataract surgery under peribulbar anesthesia.