ABSTRACT
Background and Aims: Baska mask is a newly introduced membranous cuffed supraglottic device whereas I-gel is made up of thermoplastic elastomer, both suitably designed from the anatomical perspective of the airway. Settings and Design: We conducted randomized controlled comparative trial of the Baska mask versus I-gel in a patient undergoing laparoscopic cholecystectomy. Subjects and Methods: A total of 100 adult patients in the age group of 20–70 years undergoing elective laparoscopic cholecystectomy were randomly divided into two groups as follows: (1) Baska mask group and (2) I-gel group. The primary outcome was to compare oropharyngeal leak pressure (OLP) of Baska mask and I-gel groups. The secondary outcome was the ease of insertion and removal, number of attempts, insertion time, leak fraction, and laryngopharyngeal morbidity. Statistical Analysis Used: Demographic details were compared using the Chi-square and t-tests. Student's t-test for independent variables was used to compare means of data obtained. Results: Mean OLP was significantly higher in Baska mask group than I-gel group at insertion (29.54 ± 1.41 cm H2O vs. 23.16 ± 3.07 cm H2O, P = 0.02) and 30 min after insertion (33.54 ± 1.16 cm H2O vs. 25.97 ± 2.25 cm H2O, P = 0.001). Insertion time was 12.33 ± 2.61 s with Baska mask and 11.31 ± 1.84 s with I-gel (P = 0.02). Insertion was very easy in 58% of patients in Baska mask and 76% of patients in I-gel (P = 0.03). The leak fraction of Baska mask was significantly less than I-gel (3.56 ± 3.6 vs. 7.16 ± 2.45, P = 0.01). Laryngopharyngeal morbidity was comparable in the two groups. Conclusion: Baska mask is more effective in providing greater OLP compared to I-gel without any increase in laryngopharyngeal morbidity.
ABSTRACT
Peritonitis as a result of spontaneous rupture of the uterus due to pyometra is a very rare entity. Since 1980, only a few cases of spontaneous rupture of the uterus due to pyometra have been reported in the literature. It is a diagnostic dilemma for a surgeon and a possibility of this entity though very rare should be borne in mind in an elderly female patient with diffuse peritonitis as outcome improves greatly on timely diagnosis and proper management. We present a case of peritonitis due to spontaneous rupture of the uterus due to pyometra which was diagnosed at laparotomy and managed successfully.
ABSTRACT
Mesenteric leiomyosarcoma is a rare entity. It is usually seen in middle-aged individuals. The tumor usually remains asymptomatic for longer duration until it acquires a big size. Surgical removal is the main modality of treatment. Common symptoms of the patients are usually pain or distension abdomen. Pre-operative diagnosis is usually difficult. Ultrasonography and computed tomography scan can help in the diagnosis. In this case, the tumor was mistaken for subserosal fibroid but intraoperatively turned out a mesenteric mass with retroperitoneal extension. On histopathological examination, it was a leiomyosarcoma. Reoccurrence can occur. Early diagnosis and wide surgical resection can improve the prognosis of the patient.
ABSTRACT
Nevirapine is a non-nucleoside reverse transcriptase inhibitor used as one of the first-line drugs for the highly active antiretroviral therapy (HAART) in human immunodeficiency virus positive patients. The side effects range from skin rashes to fulminant hepatotoxicity. The most of the side effects are manifested in the first 6-10 weeks indicating a need for close monitoring and follow-up of the patient in first few weeks. We hereby are presenting a case of a 41-year-old female who developed exfoliative dermatitis after 4 weeks of therapy. Keywords: Highly active antiretroviral therapy, Human immunodeficiency virus, Exfoliative dermatitis, Non-nucleoside reverse transcriptase inhibitors, Nucleoside reverse transcriptase inhibitor.
ABSTRACT
Carbamazepine is an iminostilbene derivative that was initially used as an antiepileptic but has been used with increased frequency for different indications including chronic pain, trigeminal neuralgia, and herpetic neuralgias. This has resulted in increased incidence of carbamazepine related adverse effects such as nausea, vomiting, and serious hematological toxicities such as aplastic anemia, agranulocytosis, eosinophilia, lymphadenopathy, and splenomegaly. Life-threatening hypersensitivity reactions such as Steven Johnson syndrome (SJS) and toxic epidermal necrolysis can also occur. We hereby present a series of three cases that were prescribed carbamazepine for different indications and presented with SJS.