MAMC Journal of Medical Sciences最新文献_第8页

Sequential Fracture of Neck of Femur of Both Sides in a Patient with Psychosis: A Diagnostic Dilemma 一例精神病患者双侧股骨颈连续性骨折的诊断困境

MAMC Journal of Medical Sciences Pub Date : 2022-01-01 DOI: 10.4103/mamcjms.mamcjms_27_21

D. Sabat, Prerna Kukreti

引用次数: 0

Use of TIVA as an Adjuvant to SAB in a COVID-19-positive Parturient with Morbid Obesity Posted for Emergency Caesarean Section − A Case Report TIVA作为SAB辅助剂在一例COVID-19阳性且患有病态肥胖的产妇紧急剖腹产中的应用——一例病例报告

MAMC Journal of Medical Sciences Pub Date : 2022-01-01 DOI: 10.4103/mamcjms.mamcjms_34_21

D. Gahlot, B. Wadhwa, K. Saxena

{"title":"Use of TIVA as an Adjuvant to SAB in a COVID-19-positive Parturient with Morbid Obesity Posted for Emergency Caesarean Section − A Case Report","authors":"D. Gahlot, B. Wadhwa, K. Saxena","doi":"10.4103/mamcjms.mamcjms_34_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_34_21","url":null,"abstract":"Obstetric patients offer specific anesthesia concerns and associated coronavirus disease 2019 (COVID-19) infection makes the condition more challenging. We describe anesthetic management and difficulties encountered in a parturient with multiple comorbid conditions who came for an emergency caesarean section (CS). A 32-year-old morbid obese COVID-positive female G2P1L1 at 36 weeks gestation with previous LSCS, gestational hypertension, and diabetes presented for emergency CS in view of fetal distress. She had a respiratory rate of 24 to 28/minute maintaining a saturation of 94% to 95% on oxygen at 6 to 8 L/minute. Airway examination revealed mouth opening = 2.5 cm, Mallampati classification III, neck circumference 40 cm, temporomandibular distance 3.5 cm. Surgical duration was unusually prolonged and was successfully managed with total intravenous anesthesia (TIVA) as an adjuvant to subarachnoid block. We successfully managed an emergency CS of a morbidly obese parturient with COVID-19 infection using TIVA as a rescue anesthesia to central neuraxial block, avoiding conversion to general anesthesia, minimizing aerosolization and associated risk.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49636267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Anesthetic Management in Pediatric Patient with Moyamoya Disease in Orthopaedic Surgery: “Managing the Precarious Circulation” 小儿骨科烟雾病患者的麻醉管理:“控制不稳定循环”

MAMC Journal of Medical Sciences Pub Date : 2022-01-01 DOI: 10.4103/mamcjms.mamcjms_3_21

M. Manohar, B. Wadhwa, K. Saxena, D. Gahlot

{"title":"Anesthetic Management in Pediatric Patient with Moyamoya Disease in Orthopaedic Surgery: “Managing the Precarious Circulation”","authors":"M. Manohar, B. Wadhwa, K. Saxena, D. Gahlot","doi":"10.4103/mamcjms.mamcjms_3_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_3_21","url":null,"abstract":"A 12-year-old female, diagnosed case of Down phenotype with Moyamoya disease (MMD) was posted for internal fixation of compound fracture shaft of femur. Preanesthetic evaluation revealed history of acute URI, abnormal body movements, left hemiparesis and mental retardation. Patient was managed under general anesthesia with proseal LMA and caudal epidural was administered for adequate analgesia in the perioperative period. The goal of anaesthetic management in a case of MMD is to maintain the balance between cerebral metabolic oxygen consumption rate (CMRO2) and cerebral blood flow (CBF) in order to prevent any neurologic morbidity. Though there is no ideal anaesthetic agent in MMD, the anaesthetic technique should ensure normotension, normocapnia and normothermia in the perioperative period. To our knowledge regional analgesia has not been used in the pediatric orthopedic surgeries in patients diagnosed with Moya moya. The technique of general anaesthesia supplemented with caudal epidural analgesia ensures that all the anesthetic goals are met adequately and the precarious cerebral circulation in moya moya patient is not compromised.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46539098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mental Health Tool-Kit for Healthcare Professionals 医疗保健专业人员心理健康工具包

MAMC Journal of Medical Sciences Pub Date : 2021-05-01 DOI: 10.4103/MAMCJMS.MAMCJMS_94_20

Shreya Sood, Arpita Gupta

引用次数: 0

A Rare Case of COVID-19 Infection Presenting as Massive Pericardial Effusion in Young Adult 一例罕见的年轻人出现大量心包积液的新冠肺炎感染病例

MAMC Journal of Medical Sciences Pub Date : 2021-05-01 DOI: 10.4103/mamcjms.mamcjms_78_21

Sharad Joshi, Nitesh Tayal, Ankit Bhatia

引用次数: 1

Kienbock’s Disease with Volar Intercalated Segment Instability: A Therapeutic Dilemma Kienbock病伴掌侧插入节段不稳定:一个治疗难题

MAMC Journal of Medical Sciences Pub Date : 2021-05-01 DOI: 10.4103/mamcjms.mamcjms_118_20

S. Arora, A. Sankaran, A. Dhal

引用次数: 0

How Do Residency Match Applicants Fight Battle Against COVID-19 Storm? 住院医师匹配申请人如何对抗COVID-19风暴?

MAMC Journal of Medical Sciences Pub Date : 2021-05-01 DOI: 10.4103/mamcjms.mamcjms_106_20

Vaibhav Aggarwal

引用次数: 0

Extrapulmonary Tuberculosis and Its Association with HIV in Patients Hospitalized in a Tertiary Care Center: A Cross-Sectional Study 三级医疗中心住院患者的肺外结核病及其与HIV的相关性：一项横断面研究

MAMC Journal of Medical Sciences Pub Date : 2021-05-01 DOI: 10.4103/MAMCJMS.MAMCJMS_67_20

N. Murthy, S. Umesh, G. Ravindran

{"title":"Extrapulmonary Tuberculosis and Its Association with HIV in Patients Hospitalized in a Tertiary Care Center: A Cross-Sectional Study","authors":"N. Murthy, S. Umesh, G. Ravindran","doi":"10.4103/MAMCJMS.MAMCJMS_67_20","DOIUrl":"https://doi.org/10.4103/MAMCJMS.MAMCJMS_67_20","url":null,"abstract":"Context: Extrapulmonary tuberculosis (EPTB) presentation can be unusual, and the diagnosis may often be challenging when associated with HIV. Aims: This study was conducted to find out the pattern of newly diagnosed EPTB in hospitalized patients, the diagnostic modalities used to arrive at the diagnosis, frequency of HIV positivity among them, and its association with CD4 counts. Settings and Design: All patients newly diagnosed to have EPTB admitted in a tertiary care medical college hospital in various departments over 1 year were included. Methods and Materials: Clinical presentation, comorbidities, and investigations done to arrive at diagnosis of EPTB were recorded. They were classified based on the affected site. HIV was tested for all patients, and CD4 counts in positive patients. Results: A total of 230 patients were newly diagnosed to have EPTB. The median age was 35 years (IQR 29–45), and the proportion of males was 127 (55%). Imaging was used alone in 47 (20%) patients and in combination with cytology or biopsy in 133 (57.8%) patients to establish the diagnosis. Pleural effusion, 50 (21.7%) patients, peripheral lymph node TB (LNTB), 44 (19.1%) patients, and CNS TB, 37 (16.1%) patients, were the most common forms. HIV was associated in 61 (26.5%) patients and diabetes in 27 (11.5%) patients. Both diseases influenced the presentation of EPTB. There was an association between HIV positivity and type of EPTB with peripheral LNTB being the most common in HIV patients. High CD4 counts were associated with pleural effusion and low counts with disseminated forms. Statistical Analysis Used: chi-square, ANOVA, and Student t test. Conclusion: The pattern of EPTB changes with HIV and vigilance is required to detect severe and disseminated forms of EPTB with lower CD4 counts.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48833572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of Single-Dose Ivermectin on Virologic and Clinical Recovery in COVID-19: A Randomized Controlled Trial 单剂量伊维菌素对COVID-19病毒学和临床恢复的疗效:一项随机对照试验

MAMC Journal of Medical Sciences Pub Date : 2021-05-01 DOI: 10.4103/mamcjms.mamcjms_77_21

Romit Saxena, Muthu Rajanagam, U. Jhamb, V. Manchanda, S. Saxena, Pallavi

{"title":"Efficacy of Single-Dose Ivermectin on Virologic and Clinical Recovery in COVID-19: A Randomized Controlled Trial","authors":"Romit Saxena, Muthu Rajanagam, U. Jhamb, V. Manchanda, S. Saxena, Pallavi","doi":"10.4103/mamcjms.mamcjms_77_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_77_21","url":null,"abstract":"Background: Coronavirus disease 2019 (COVID-19) pandemic mounts an ever increasing challenge on healthcare resources. Ivermectin shows promise in in vitro studies on coronavirus, but there are few prospective trials on currently approved dosage recommendation for the treatment of COVID-19. Aims: To study the virologic and clinical recovery after single-dose ivermectin, given within first 5 days of symptom onset. Settings and design: Prospective, open-labeled, randomized controlled trial. Patients were recruited in between August 30, 2020, and November 6, 2020, at a single referral center for patients with COVID. Materials and methods: The study participants included patients presenting with severe acute respiratory syndrome coronavirus 2 infection. The patients were randomized to receive a single-dose ivermectin, 0.2 mg/kg in the treatment group (TG). Both groups [TG and control group (CG)], continued to receive standard treatment. Results: The recruited cohort was comparable in the two arms of the study, except age and height. There was no statistically significant difference in virologic clearance between the two arms (percentage COVID positive day 7: TG: 34.2% vs. CG: 52.6%, P = 0.165). Conclusion: Our study shows that after administration of single dose of currently approved doses of ivermectin (0.2 mg/kg), there does not exist a significant virologic or clinical recovery in COVID-19 disease.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47189852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The New Normal Anesthesiologist and the Challenging Post-COVID-19 Mucormycosis Patients − Our Experience 新常态麻醉师与具有挑战性的COVID-19后毛霉菌病患者——我们的经验

MAMC Journal of Medical Sciences Pub Date : 2021-05-01 DOI: 10.4103/mamcjms.mamcjms_71_21

S. Wadhawan, F. Husain, M. Agarwal

引用次数: 0