Long-term outcomes and predictors of mortality in patients with pulmonary embolism undergoing catheter-directed thrombolysis: a 10-year retrospective study.

Background: Data regarding long-term outcomes of catheter-directed thrombolysis (CDT) post intermediate risk pulmonary embolism (PE), the choice of anticoagulation, and factors affecting mortality are not well studied.

Methods: We conducted a ten-year retrospective observational chart review of patients undergoing CDT for intermediate-risk PE. Patients were followed for a period of 1 to a maximum of 5 years from the PE event.

Pulmonary Langerhans Cell Histiocytosis: An Unusual Differential for a Solitary Lung Nodule.

Background: Pulmonary Langerhans cell histiocytosis (LCH) commonly presents as bilateral reticulonodular and cystic lung changes on chest imaging. Isolated lung nodule presentation is rare. .

A Rare Case of Late-Onset Ertapenem-Induced Encephalopathy.

Encephalopathy is a rare side effect associated with carbapenem antibiotics, typically presenting within one week of initiating treatment. It is almost exclusively seen in patients with poor renal function. We present a case of a middle-aged male with a history of cerebral vascular accident and normal renal function admitted for agitation, delirium, and insomnia more than two weeks after starting ertapenem to treat osteomyelitis.

Idiopathic hypereosinophilic syndrome presenting as cardiac tamponade and multiorgan dysfunction.

Idiopathic hypereosinophilic syndrome is characterised by the overproduction of eosinophils with tissue infiltration, leading to multiorgan dysfunction. Its heterogenous presentation makes the diagnosis challenging and easy to miss. A woman in her 70s was admitted with chest pain and shortness of breath.

A Case of Immunoglobulin G4-Related Disease Presenting as a Parapharyngeal Mass.

Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition characterized by tissue infiltration with lymphocytes and IgG4-secreting plasma cells. The presentation of IgG4-RD is heterogenous, making it difficult to diagnose. IgG4-RD presenting as a parapharyngeal mass is extremely rare.

A Case of Rosai-Dorfman Disease Presenting as an Isolated Pleural Plaque.

Rosai-Dorfman disease (RDD) is a rare non-Langerhans histiocytic disorder primarily involving lymph nodes. Extranodal RDD has a heterogenous presentation, and isolated pulmonary involvement is rare. We report the only case of RDD presenting as an isolated pleural mass.

Mitral Annular Disjunction: A Scoping Review.

Mitral annular disjunction (MAD) is the atrial displacement of the mitral valve (MV) hinge point, especially along the posterior mitral leaflet, which leads to inhomogeneous blood flow into the left ventricle, causing chronic fibrotic changes, malignant arrhythmias, and even sudden cardiac arrest. Some studies suggest that MAD is a part of normal heart morphology; however, the origin is still controversial. MAD commonly occurs with MV prolapse and myxomatous degenerative MV disease.

Cystic Lung Disease Presenting as Recurrent Non-traumatic Chylothorax: Case Report and a Mini-Review.

Malignancy and infections are the most common causes of recurrent chylothorax. Cystic lung disease, especially sporadic pulmonary lymphangioleiomyomatosis (LAM), is a rare condition that may manifest as recurrent chylothorax. We present a case of a 42-year female who presented with dyspnea on exertion secondary to recurrent chylothorax, requiring three thoracenteses within a few weeks.

Spontaneous Resolution of Recurrent Pleural Effusion in Atraumatic Splenic Rupture.

Spontaneous splenic rupture is an uncommon cause of acute-onset left-sided pleural effusion. It is often immediate with a high preponderance for recurrence, sometimes even requiring splenectomy. We report a case of spontaneous resolution of recurrent pleural effusion presenting a month after the initial atraumatic splenic rupture.

A Case of the Unveiling of Pulmonary Pseudoaneurysm Masquerading as a Lung Mass.

Pulmonary artery pseudoaneurysm (PAP) is an abnormal dilatation of the pulmonary vessels. They can mimic the appearance of lung nodules on chest X-rays and noncontrast CT imaging of the chest. We present a case of PAP masquerading as a lung mass for five years before presenting as a pulmonary hematoma.

Life-Threatening Acidosis With Metformin and Dapagliflozin Combination Therapy: A Case Report.

Euglycemic keto-acidosis is a known complication of dapagliflozin. However, acidosis can be life-threatening when dapagliflozin is used as a combination therapy with metformin. Our patient was a 64-year-old male, with a history of well-controlled type 2 diabetes mellitus on metformin and dapagliflozin, admitted with vomiting and diarrhea for several days.

Identification of patients for a delayed extubation strategy versus elective tracheostomy for postoperative airway management in major oral cancer surgery: A prospective observational study in seven hundred and twenty patients.

Objectives: Tracheostomy (TT) and delayed extubation (DE) are two approaches to postoperative airway management in patients after major oral cancer surgery. We planned a study to determine the safety of overnight intubation followed by extubation the next morning (DE) compared to elective TT and to identify factors that were associated with a safe DE (maintenance of a patent airway).

Material And Methods: We conducted a prospective observational study in a tertiary referral cancer care center.

Anesthesia for oral surgeries during the COVID-19 pandemic.

The severe acute respiratory syndrome corona virus 2(SARS-Cov2) virus replicates in the nasal cavity, nasopharynx, and the oropharynx. During oral surgery, the risk of viral transmission is high during instrumentation in these areas, while performing airway management procedures, the oral surgery itself, and related procedures. During the corona virus disease 2019 (COVID-19) pandemic, patients with an oral pathology usually present for emergency procedures.

Massive Engorgement of a Hemangioma of the Tongue After General Anesthesia Using a Supraglottic Airway Device: A Case Report.

We report a case of massive engorgement of an asymptomatic tongue hemangioma with the use of a supraglottic airway device (SGA) during general anesthesia for transurethral resection of a tumor on the lateral wall of the urinary bladder. This was probably a result of obstruction of the venous drainage of the hemangioma due to the pressure exerted by the inflated cuff of the SGA. The SGA was removed and the trachea was intubated and the engorgement resolved completely in a few hours.

Opioid-free anesthesia-caution for a one-size-fits-all approach.

Post-operative pain management should ideally be optimized to ensure patient's mobilization and ability to partake in effective pulmonary exercises for patient's early recovery. Opioids have traditionally been the main mode for analgesia strategy in the perioperative period. However, the recent focus on opioid crisis in the USA has generated a robust discussion on rational use of opioids in the perioperative period and also raised the concept of "opioid-free anesthesia" in certain circles.

Supraglottic jet oxygenation and ventilation - A novel ventilation technique.

Supraglottic jet oxygenation and ventilation (SJOV) is a novel minimally invasive supraglottic technique of jet ventilation which has shown superior results in maintaining oxygenation without any major complications. Theoretically, it could maintain PaO and PaCO within physiological limits for as long as required, the maximum duration reported till now is 45 min. The distinct advantage of SJOV over techniques of nasal oxygenation is its ability to record EtCO during the periods of ventilation.

Role of organochlorine pesticides in children with idiopathic seizures.

Background. Organochlorine pesticides (OCP) are persistent organic pollutants that have been implicated in causing several deleterious effects in humans. These are known neurotoxins in high doses, but the role of environmentally acquired OCPs in the body to induce seizures in children has not been investigated yet.

Predictors of meningitis in children presenting with first febrile seizures.

No data exist on the prevalence of meningitis in a first episode of seizures with fever in the Indian population. We investigated the prevalence of bacterial meningitis in children aged 6-18 months presenting with a first episode of seizures with fever, and we assessed clinical predictors of bacterial meningitis in these patients. We analyzed clinical and investigative profiles of 497 children, aged 6-18 months, admitted to pediatric casualty wards with a diagnosis of first febrile seizures.

Mortality from Influenza A/H1N1 in a tertiary care teaching institution in North India.

Background: The recent influenza A/H1N1 pandemic has caused considerable morbidity and some mortality and is therefore a severe threat to certain individuals. Up to 31 January 2010, there had been 1,229 confirmed deaths from Influenza A/H1N1 in India.

Methodology: This study was a retrospective analysis of deaths caused by RT-PCR-confirmed cases of Influenza A/H1N1 in a tertiary care institution in North India from September 2009 until January 2010.