Efficacy of intravenous vitamin C in management of moderate and severe COVID-19: A double blind randomized placebo controlled trial.

Aim: To study the efficacy of intravenous vitamin C in management of moderate and severe COVID-19.

Objective: To determine the efficacy of intravenous vitamin C in reducing in-hospital mortality in moderate and severe cases of COVID-19.

Design: Parallel, double-blinded randomized controlled trial with placebo.

Peripheral nerve stimulator guided erector spinae plane block for post-operative analgesia after total abdominal hysterectomies: A feasibility study.

Background And Aims: The pain following total abdominal hysterectomy (TAH), a very commonly performed gynaecological surgery, is usually taken care of by various opioids, non-opioids, regional and peripheral nerve blocks. Erector spinae plane block (ESPB) under ultrasound guidance is a relatively new approach for postoperative analgesia in thoracic and abdominal surgeries. Ultrasound availability and expertise to use it is a limitation at times.

Efficacy of Baska mask as an alternative airway device to endotracheal tube in patients undergoing laparoscopic surgeries under controlled ventilation.

Background And Aims: Newer supraglottic devices with an additional gastric channel offer greater protection from aspiration and avoidance of laryngoscopy for their insertion would result in attenuated hemodynamic responses.The primary objective was to assess hemodynamic responses to insertion of Baska mask as compared to tracheal intubation. The time and attempts taken to secure airway and evidence of regurgitation and pulmonary aspiration of gastric contents were also assessed.

Effect of dexmedetomidine on intracranial pressures during laparoscopic surgery: A randomized, placebo-controlled trial.

Background And Aims: Laparoscopic surgeries cause an increase in intracranial pressure (ICP) after creation of pneumoperitoneum. Sonographically measured, optic nerve sheath diameter (ONSD) correlates well with changes in ICP. Dexmedetomidine (Dex), an α agonist is extensively used in day-care surgeries, although its effect on ICP during laparoscopy in humans has not been reported in the literature.

Role of neomycin polymyxin sulfate solution bladder wash for prevention of catheter associated urinary tract infection in traumatic brain injury patient admitted to Intensive Care Unit: A prospective randomized study.

Background: Catheter - associated urinary tract infection (CAUTI) remains a critical threat for patients in intensive care unit especially in traumatic brain injury patients with low Glasgow coma score (GCS). Almost all patients in ICU receive antibiotic either prophylactic or therapeutic based on local antibiogram of particular ICU or hospital. For prophylaxis, systemic antibiotics are used.

Effect of nasal oxygen supplementation during apnoea of intubation on arterial oxygen levels: A prospective randomised controlled trial.

Background And Aims: Apnoeic oxygenation during laryngoscopy has been emphasised in recent recommendations for airway management. We aimed to compare the effect of nasal oxygen supplementation on time for pulse oximeter oxygen saturation (SpO) to fall from 100% to 92% (desaturation safety time), to assess the arterial oxygen partial pressures (PaO) with and without nasal oxygen supplementation and the time for SpO to recover from 92% to 100% after initiation of ventilation.

Methods: This is a prospective randomised placebo-controlled trial involving sixty patients, where nasal oxygen supplementation given at 10 L/min during apnoea of laryngoscopy in one group of patients (Group O) was compared to no oxygen supplementation in other group (Group NoO).

Dual Oxygen Therapy in Patient on Bilevel Positive Airway Pressure Prevented Invasive Mechanical Ventilation.

During noninvasive bilevel positive airway pressure (BiPAP) ventilation it is found that several times patients are unable to maintain oxygen saturation and develop breathing difficulty despite its high setting and high oxygen flow, further management requires invasive positive pressure mechanical ventilation. Increasing oxygen concentration inside the BiPAP mask using nasal cannula with addition of another flow meter not only increase oxygen saturation but also make the patient more comfortable and prevent intubation and its complications. This dual oxygen therapy is particularly useful in patients where non invasive ventilation is required and avoiding the need invasive mechanical ventilation.

Effect of Pneumoperitoneum and Patient Positioning on Intracranial Pressures during Laparoscopy: A Prospective Comparative Study.

Study Objective: To evaluate the effect of pneumoperitoneum and head position during laparoscopic surgery on intracranial pressures (ICPs) using sonographic measurements of optic nerve sheath diameter (ONSD).

Design: Prospective observational study (Canadian Task Force classification II-1).

Setting: A tertiary-level hospital.

A comparison of dexamethasone and clonidine as an adjuvant for caudal blocks in pediatric urogenital surgeries.

Background: Caudal block is a reliable regional analgesic technique for pediatric urogenital surgeries. Various adjuvants have been tried to enhance the duration of action of bupivicaine. Though clonidine is extensively used as an adjuvant in caudal anaesthesia, it can have troublesome adverse effects like bradycardia, hypotension and sedation.

Self injury of extremities leading to amputation while handling local bomb.

Self injury while making material which has a tendency to blast is dangerous- whether it is fire cracker or local bomb. Some villagers living nearby forest make bomb to scare wild animals to protect their pet animals. A 22-year old girl while making this kind of local bomb, got injured badly.

Management of difficult airway in penetrating cervical spine injury.

Management of airway in trauma victim with penetrating cervical/thoracic spine injury has always been a challenge to the anaesthesiologist. Stabilisation of spine during airway manipulation, to prevent any further neural damage, is of obvious concern to the anaesthesiologist. Most anaesthesiologists are not exposed to direct laryngoscopy and intubation in lateral position during their training period.

A rare presentation of invasive rhino-orbital mucormycosis in an immunocompetent young girl: a case report.

A 18 year young, healthy, immunocompetent girl presented with proptosis of left eye, referred to eye OPD, suspected clinico-radiologically as malignancy. This presentation with suspicion of malignancy resulted into extensive surgical debridement with removal of left eye, which was diagnosed as mucormycosis on histopathological examination. Her eye could have been saved if the mucormycosis was highly suspected initially, because of the good general health and immunocompetency led to misdirected thought.

Is fine needle aspiration cytology (FNAC) useful in skin adnexal masses? A study on 5 cases of pilomatixoma.

Superficial cutaneous/subcutaneous nodules, caused by a variety of inflammatory, benign and malignant pathology of diverse origin, are tempting lesion for fine needle aspiration cytology (FNAC). Amongst these, adnexal tumor show considerable overlap, both in clinical manifestation as well as in histopathology. Archieval records of clinical findings, FNAC smears and reports pertaining to 5 histologically proved cases of pilomatricoma (PMX) were analyzed.

Scorpion sting envenomation presenting with pulmonary edema in adults: a report of seven cases from Nepal.

Scorpion sting is a common problem in villages of Eastern Nepal. The life-threatening complications of myocarditis and pulmonary edema is known in red scorpion in India but not reported in Nepal. This condition requires urgent attention and ICU care from few hours to days.