Malignant hyperthermia: survival without dantrolene - a case report

We encountered a case of malignant hyperthermia in a 52 year old male undergoing open reduction/internal fixation of humerus fracture under general anesthesia. Isoflurane has been reported as a potent triggering agent of malignant hyperthermia. Dantrolene remains the gold standard for treating this life threatening syndrome but it is not available in many countries including Pakistan. However, we successfully managed our patient by timely recognition of this syndrome and administering prompt and effective symptomatic treatment

Empyema thoracis: a rare presentation

We present a case of spontaneous rupture into tracheohronchial tree of a large collection of pus in the during induction of anaesthesia. This event made active ventilation and oxygenation of the patient impossible till most of the pus was drained or seutioned. Prompt lateral positioning of the patient in this case the diseased lung dependant is important to prevent the healthy lung from soiling

study of 86 cases of abdominal tuberculosis

The aim of this study was to evaluate the varied presentation, morbidity/ mortality and outcome of various surgical procedures done in patients with abdominal tuberculosis. Case Series. Surgical Unit III and IV Bolan Medical College Complex Hospital Quetta, from January 2005 to June 2007. All those patients who were clinically suspected to have abdominal tuberculosis, supported by investigation and gross morphological findings at surgery and histopathologically proven caseating granulomas were included in this study. A total of 86 patients were managed during the study period. The mean age of patients was 35.6 years and male to female ratio of 1:2. Primary intestinal tuberculosis was found in 78%. About 52.3% of patients had single or multiple strictures involving the distal ileum and ileocaecal region. 27.9% of patient had mass in the ileocaecal region. Perforation was recorded in 19.8% cases. Mortality was 2.3%. Major postoperative complications occurred in 13.9% of patients. All patients were prescribed anti tuberculosis drugs for a period of 12 months. The median follow up was 6 month. 82.5% of patients were doing well till the last visit. Patients who present with bowel obstruction especially sub acute or chronic, should have a complete workup to prove or rule out intestinal tuberculosis. In the presence of bowel perforation with faecal peritonitis and intra-abdominal sepsis, ileostomy is a safer procedure than primary anastomosis