RESUMO
Primary pulmonary synovial sarcoma is a very rare tumor. This tumor accounts for less than 0.5% of all lung neoplasia. While synovial sarcomas are commonly reported from periarticular tissues, they are often found in lung or thorax as a metastasis from an extrapulmonary primary. However, rarely they arise primarily from lung tissue. We report a case of primary pulmonary synovial sarcoma which was indenting the right side of the heart. He was managed with neoadjuvant chemotherapy followed by surgical resection. The anesthetic management was challenging. The focus was kept on stringent invasive as well as non-invasive monitoring of cardiac and respiratory parameters. The surgery was uneventful and the patient made a successful recovery.
RESUMO
Dynamic airway obstruction (also called ball-valve effect) is a serious condition often seen in glottic lesions. This is an anesthetic challenge as total airway obstruction can occur after the induction of general anesthesia. We present a case of a middle aged female who had a large laryngeal mass which was showing ball-valve effect. The patient had refused for tracheostomy despite it being the safest procedure in the circumstances. We then performed videolaryngoscopy and managed to intubate the patient with the help of some improvisation. The patient underwent a succesful and uneventful surgery.
RESUMO
Thyroidectomy is the treatment of choice for large retrosternal goiters. These tumors often are large enough to require thoracotomy. Robotic surgery can help in avoiding thoracotomy and its associated post operative complications. Rarely, such tumors and their surgery can be complicated by tracheal tears. Such tears, especially those near the carina are difficult to repair and often require open thoracotomy. We described such a case where we avoided open thoracotomy and instead performed a minimally invasive robotic repair of tracheal tear. The maintenance of ventilation during this robotic repair was critical. A combination of several airway devices was used to allow the complex surgical repair to be executed without affecting ventilation.
RESUMO
Background: Obesity is described as a build-up of abnormal or excessive fat that risks life. A body mass index (BMI) is a screening tool for overweight and obesity. For a long time, BMI has been used as a marker to measure obesity. However, a significant limitation of using BMI is its failure to differentiate between a high body fat content and preserved or increased lean mass, especially in patients or subjects with a BMI <30 kg/m2. Normal weight obese (NWO) is such individuals who have high fat content but a normal BMI. To identify such individuals and to save them from morbidity associated with obesity, this study was carried out. Aims and Objectives: The objective of the study was to estimate the prevalence of NWO in healthy young adults (aged between 18 and 30 years) and to suggest the methods of primary prevention for obesity. Materials and Methods: In this observational cross-sectional study, the 324 subjects were selected randomly from the residents, students, and employees of Swami Vivekananda Subharti University. Subjects were chosen according to the study’s inclusion and exclusion criteria and also, based on the self-structure questionnaire. A general and systemic examination was carried out. The body composition of these subjects was done by bioelectric impedance analyzer BODY STAT QUAD SCAN 4000. Data were analysis using R-software (1.25 version), and unpaired t-test was applied. P < 0.05 was taken as significant in this study. Results: The prevalence of NWO in males was found to be 24.6% and females to be 13.4%. The body composition parameters of NWO and NWNO differed significantly. Conclusion: The increase rate of NWO is reason for concern and routine screening of body composition parameters should be done at health setups to identify that these NWO individuals and timely interventions can be made.