Efficacy of dexmedetomidine with hyperbaric bupivacaine for postoperative analgesia in appendectomy: A randomized controlled trial.

Background: Optimal pain control following surgery plays a vital role in promoting faster recovery. This research explores the effectiveness of adding dexmedetomidine to hyperbaric bupivacaine in enhancing postoperative analgesia for patients undergoing emergency open appendectomy under spinal anesthesia.

Methods: In this prospective, randomized, double-blind study, 69 patients aged 18 to 65 years were divided into 3 groups: Group 1 received 14 mg bupivacaine and saline; Group 2 received 14 mg bupivacaine with 2 mcg dexmedetomidine; and Group 3 received 14 mg bupivacaine with 4 mcg dexmedetomidine.

Overcoming the Challenges of Intravenous Immunoglobulin Resistance in Kawasaki Disease: A Case Report.

Kawasaki disease, extremely rare vasculitis of unknown etiology characterized by inflammation of small to medium sized arteries of multiple systems. This case report enhances the knowledge and management skills of rare clinical conditions. Here we report a case of a 3-month-old infant presented with acute onset fever, rash, non-exudative conjunctivitis and swellings of hands and legs with blood culture positive sepsis and right coronary artery dilatation.

Innovative anaesthetic approaches to severe Kyphoscoliosis in a child with congenital vertebral abnormalities: a case report.

The management of severe kyphoscoliosis in children, particularly those with congenital vertebral anomalies, presents a formidable challenge that requires a highly coordinated, multidisciplinary approach. In this case report, we delve into the complex journey of an 11-year-old female diagnosed with extreme kyphoscoliosis (Cobb's angle 90°) complicated by rib and vertebral dysplasia. This unique presentation not only demanded precision in surgical technique but also necessitated advanced anesthetic strategies and real-time intraoperative monitoring to ensure a successful outcome.

Managing Life-Threatening Tracheal Malignancy and Lung Metastases in a Young Woman: A Case of Aggressive Airway Intervention.

Infiltrative tracheal malignancies are exceptionally rare among younger individuals, but when they do occur, they present a significant and immediate risk due to severe airway compromise. Managing the airway in such cases is extremely challenging in low-resource settings and requires a highly skilled team of anesthesiologists utilizing advanced techniques. This case report outlines the airway management of a patient with an infiltrative tracheal malignancy who experienced severe airway obstruction.

Effect of isotonic sodium bicarbonate infusion on perioperative acid-base status among patients undergoing emergency laparotomy for perforation peritonitis (ISABEL trial): a randomized controlled trial.

Purpose: Perioperative metabolic acidosis negatively affects patient outcomes. Perioperative fluid therapy has a clinically significant effect on acid-base balance. This study was conducted to evaluate the effects of isotonic sodium bicarbonate infusion (ISB) versus balanced crystalloid solution (BCS) on perioperative acid-base balance, in terms of postoperative base excess, among patients undergoing emergency laparotomy for perforation peritonitis.

Extensive Subcutaneous Emphysema Following Emergency Tracheostomy in a High-Risk Patient With Advanced Supraglottic Carcinoma: Navigating Complexity.

In high-risk patients undergoing emergency tracheostomy, especially with advanced malignancies and comorbidities, vigilant monitoring and immediate management of complications like extensive subcutaneous emphysema are crucial. Prompt intervention and interdisciplinary collaboration are essential to optimize outcomes and effectively address severe postoperative issues.

Redefining Airway Management in Maxillofacial Trauma: The Strategic Implementation of Sub-Mental Intubation.

Submental intubation offers a valuable alternative for managing airway in patients with complex maxillofacial injuries, providing unobstructed access for surgical intervention and reducing complications associated with traditional intubation methods. It enhances both surgical visibility and patient safety.

A deep dive into neonatal well-being and anesthesia in cesarean sections: From procedure to outcome.

This observational study analyzed data from 502 participants undergoing cesarean section (CS) procedures at an obstetrics and gynecology department, aiming to explore anesthesia practices, neonatal outcomes, and demographic characteristics within the cohort. Participants, aged 17 to 59 years with a mean age of 32.23 years, were enrolled based on the clinical necessity for cesarean delivery during the study period.

Neurosurgical intervention for giant arachnoid cyst-induced hydrocephalus in a teenager: Delving into Pandora's box.

Early recognition and prompt surgical intervention are crucial in managing giant arachnoid cysts causing obstructive hydrocephalus, as illustrated in this case of a 17-year-old male. Timely treatment can alleviate symptoms and prevent neurologic complications, ensuring favorable outcomes in affected patients.

Successful management of carinal shift in aortic dissection: A case report of innovative airway management strategies.

The case underscores the necessity of adaptable airway management strategies in aortic dissection surgeries complicated by carinal shift. Successful lung isolation was achieved using a single-lumen endotracheal tube after failed attempts with traditional methods and bronchial blockers.

Impact of Delivery Room Gastric Lavage on Exclusive Breastfeeding Rates Among Neonates Born Through Meconium-Stained Amniotic Fluid: A Randomized Controlled Trial.

Background: Delivery-room gastric lavage reduces feeding intolerance and respiratory distress in neonates born through meconium-stained amniotic fluid (MSAF).

Objectives: To evaluate the effects of gastric lavage on exclusive breastfeeding and skin-to-skin contact in neonates delivered through MSAF.

Design: Randomized controlled trial.

Probability Distribution of Pixel Intensities of EBT3 Films and its Application in the Correction of Uncertainty Budget.

Background And Aim: Modern radiotherapy modalities, such as Intensity-Modulated Radiotherapy and Volumetric Modulated Arc Therapy involve complex dose delivery. The dose delivery is complex as it involves beam modulation, hence, manual dose calculations for these techniques are not possible. Film dosimetry is commonly used method of dose verification for these modalities because of the advantages associated with it.

Computation of epistemic uncertainty due to limited data samples in small field dosimetry using Fuzzy Set Theory.

Objective: To estimate the epistemic (or fuzzy) uncertainty, arising due to limited data samples in the measurement of the output factors (OFs) of the small fields using Fuzzy Set Theory (FST).

Methods: EBT3 film samples of size 50 × 50 mm were used for the measurement of the OF of stereotactic radiosurgery (SRS) cones of size 4, 6, 7.5, 10, 12.

Resectional surgery in gallbladder cancer with jaundice-how to improve the outcome?

Purpose: To evaluate the surgical outcomes of patients with gallbladder cancer (GBC) with jaundice due to as-yet unelucidated prognostic factors.

Methods: A total of 348 GBC patients underwent resection at our institute between 1985 and 2016. Of these, 67 had jaundice (serum total bilirubin ≥ 2 mg/dL).

Performance Validation of In-House Developed Four-dimensional Dynamic Phantom.

Objective: The objective of this study was to validate the performance characteristics of in-house developed four-dimensional (4D) dynamic phantom (FDDP).

Materials And Methods: There are three target inserts of 1.0, 1.

Surgery in node-positive gallbladder cancer: The implication of an involved superior retro-pancreatic lymph node.

Background: The treatment approach to node-positive gallbladder cancer has unresolved issues with regard to the management of patients with a positive superior retro-pancreatic (level 13a) node, which is the highest level of spread. The American Joint Committee on Cancer remains unclear on the status of the 13a node.

Methods: This retrospective study consisted of 165 patients with node-positive gallbladder cancer without distant metastasis.

Lacunae in International Federation of Gynecology and Obstetrics (FIGO) classification for cervical carcinoma: observational study using TNM classification as comparator.

Purpose: International Federation of Gynecology and Obstetrics (FIGO) staging for cervical cancer does not yet consider findings of cross-sectional imaging unlike clinical tumor, node, and metastasis (TNM) staging system. We compare the two with regard to accuracy in pretreatment staging and their reliability in the prediction of prognosis.

Materials And Methods: This was an observational study of patients with biopsy-proven nonmetastatic cervical carcinoma.

Influence of comorbidity in cancer surgery on treatment decisions, postoperative course and oncological outcome.

Aim: Comorbidity in cancer patients may influence treatment decisions, postoperative morbidity and ultimately, survival. The TNM staging system does not take comorbidity into account. This study investigates the burden of comorbidity in cancer patients, its effect on resection rate, postoperative morbidity, adjuvant therapy, recurrence and survival.

Disseminated peritoneal hydatidosis following blunt abdominal trauma: A case report.

A middle age lady presented with abdominal pain was diagnosed to have multiple peritoneal and hepatic hydatid cysts on CT scan. Retrospectively she was found to have suffered blunt abdominal trauma.