OBJECTIVES Reducing variability is integral in quality management. As part of the ongoing Encephaloduroarteriosynangiosis Revascularisation for Symptomatic Intracranial Arterial Stenosis (ERSIAS) trial, we developed a strict anaesthesia protocol to minimise fluctuations in patient parameters affecting cerebral perfusion. We hypothesise that this protocol reduces the intraoperative variability o...

BACKGROUND Failure to achieve fascial closure after damage control laparotomy (DCL) is associated with increased morbidity and long-term disability. In addition, early closure is associated with reduces infectious, wound, and pulmonary complications. We hypothesized that hypertonic saline (HTS), which attenuates resuscitation-induced intestinal edema in animals, would improve early primary fasc...

A 42-year-old man with history of esophageal strictures and esophageal dilation presented to the emergency department with 12 hours of dysphagia and non-bloody emesis. His symptoms started upon waking and included sharp retrosternal pain during each attempt at swallowing. Dysphagia occurred with both solids and liquid. He denied difficulty initiating swallowing, pain with eating the previous ni...

OBJECTIVE To establish the role of high-fidelity simulation training to test the efficacy and safety of the electronic health record (EHR)-user interface within the intensive care unit (ICU) environment. DESIGN Prospective pilot study. SETTING Medical ICU in an academic medical centre. PARTICIPANTS Postgraduate medical trainees. INTERVENTIONS A 5-day-simulated ICU patient was developed ...

BACKGROUND AND AIMS This study aimed to understand the use of massive transfusion (MT) for gastrointestinal bleeding (GIB). PATIENTS AND METHODS We performed a retrospective analysis of patients admitted to our medical Intensive Care Unit (ICU) with GIB for the type of bleeding, quantity of blood products transfused, and risk of transfusion-related acute lung injury (TRALI) and death. MT was ...

Sir, U pleural e f fus ions are common secondary to Mycobacterium tuberculosis infection in developing countries. However, new onset pleural effusion after start of anti-tuberculous therapy or recurrent pleural effusions are rare occurrences. We, hereby, present a young girl diagnosed to have tuberculous effusion developed recurrent pleural effusion on initiation of therapy and raised the possi...

INTRODUCTION Laparoscopic cholecystectomy (LC) is conventionally performed under general anaesthesia (GA) in our institution. There are multiple studies which have found spinal anaesthesia as a safe alternative. We have conducted this study of LC, performed under spinal anesthesia to assess its safety and feasibility in comparison with GA. MATERIALS AND METHODS Fifty patients with symptomatic...

Abstract Background Corona virus disease has been associated with a wide variety of fungal and bacterial co-infections. These secondary infections could be due to the irrational use antibiotics, immunosuppressive therapy, pre-existing co morbidities, immune modulator effects virus. But here, we report very rare occurring rhino-orbito-cerebral invasive sinusitis in malnourished child no other mo...

Adrenal myelolipoma is a benign neoplasm of the adrenal gland that second most common primary incidentaloma, following adrenocortical adenomas. It composed elements adipose tissue and with varying amounts hematopoietic components. In past, these tumors were discovered at autopsy, an incidence ranging from 0.08% to 0.4%. Today, widespread use radiological studies such as ultrasonography, compute...

Boerhaave syndrome (BS) is a full thickness oesophageal tear. Most cases require surgical correction. In rare cases, conservative management can be attempted. This case describes 30-year-old patient with history of BS 9 months prior, managed conservatively at that time, presenting 2 days vomiting. Their vitals and physical examination were within normal limits. Imaging revealed extensive air tr...