Cortical Blindness and Thrombotic Microangiopathy Following a Hemotoxic Snake Envenomation: An Unusual Presentation.

Snake envenomation leads to significant morbidity and mortality with local, hematological, renal, and neurological complications. Hemotoxic envenomation activates a hemorrhagic cascade, leading to many manifestations ranging from skin bleeds to major organ bleeds and fatal intracranial hemorrhage. Although rare, ischemic manifestations are possible following a hemotoxic envenomation, and they may present as cortical blindness, an unusual ocular symptom.

Anaesthetic management of forearm fractures using a combination of haematoma block and intravenous regional anaesthesia.

Background: Intravenous regional anaesthesia (IVRA) has been successfully used as a sole technique for forearm fractures and has high success rates. However, it is uncomfortable for the patient when the fresh fracture is manipulated for conduct of IVRA. Haematoma block (HB) has also been demonstrated as an effective anaesthetic technique for treatment of radial fractures in the ER.

Unusual case of focal neck swelling: Phlebectasia of internal jugular vein with intracranial extension.

Internal jugular vein (IJV) phlebectasia is rare in occurrence and is frequently misdiagnosed and managed inappropriately. It commonly presents as a unilateral neck swelling which typically increases in size with valsalva maneuver. Although, the most common cause of a focal neck swelling, which increases in size with valsalva maneuver is laryngocele, the possibility of phlebectasia of IJV should always be borne in mind, especially in child.

Blood transfusion practices in sepsis.

Sepsis is a clinical syndrome characterised by systemic inflammation due to infection. There is a spectrum with severity ranging from sepsis to severe sepsis and septic shock. Even with optimal treatment, mortality due to severe sepsis or septic shock is significant and poses a challenge to management.

Clinical efficacy of a novel new injectable diclofenac formulation designed for intradeltoid use in post-operative pain management.

Objective: A randomized study comparing efficacy and safety of a new 75 mg/1 ml formulation of injectable diclofenac sodium designed for intra-deltoid use with the conventional 75 mg/3 ml formulation given by the intra-gluteal route.

Design: This was an open-label, multicentric, randomized clinical trial.

Methods: A total of 250 adult patients with post-operative pain were randomized to receive either an injection diclofenac 75 mg/1 ml or diclofenac 75 mg/3 ml.

Anaesthetic management of carinal resection and reconstruction-a case report.

Anaesthetic management of surgery for tumors involving the carina is very challenging for an anaesthesiologist and has been associated with guarded prognosis. We describe the management of carinal resection and reconstruction due to a tracheal tumor involving the carina. The various anaesthetic issues involved and experienced in this clinical setting are described.

Cardio Cerebral Resuscitation: Is it better than CPR?

The guidelines for cardiopulmonary resuscitation (CPR) have been in place for decades; but despite their international scope and periodic updates, there has been little improvement in survival rates in out-of-hospital cardiac arrest for patients who did not receive early defibrillation. Instituting the new cardio cerebral resuscitation protocol for managing prehospital cardiac arrest improved survival of adult patients with witnessed cardiac arrest and an initially shockable rhythm.

Sedation Guidelines for Gastro Intestinal Endoscopy.

Effective sedation is usually a vital precursor to any successful endoscopic procedure. With advanced techniques and medications available today this component of the procedure can be dealt with safely and in an efficient manner.

Organ Donation : Intensive Care Issues in Managing Brain Dead.

Organ donation and transplantation is one of the most powerful and dramatic practices in modern medicine. It is the pinnacle of centuries of dreams, massive amounts of accrued knowledge and impressive technical developments. One organ donor has the potential of saving more than five lives and impacting the quality of life of many others via tissue donation.

Anaesthetic Issues in In-vitro Fertilisation.

Background: Ultrasonically guided transvaginal oocyte retrieval is a relatively short procedure that is performed on an outpatient basis. Any anaesthetic technique may interfere with certain aspects of human oocyte fertilisation or embryo implantation. The optimal anaesthetic technique should allow good surgical anaesthesia with minimal side effects, a short recovery time and high rate of successful pregnancy.

Gastric Tonometry as a Prognostic Index of Mortality in Sepsis.

Background: Splanchnic hypoperfusion in sepsis leads to translocation of bacteria from gut and development of multi-organ dysfunction syndrome (MODS), with increased mortality in critically ill patients. Gastric tonometry can detect this hypoperfusion by measuring carbon dioxide tension (PgCO2) and intramucosal pH (pHi) from gastric mucosa. Therapeutic intervention aimed at improving gut perfusion can improve the outcome and prognosticate the mortality in sepsis patients.