ABSTRACT
Spontaneous pneumomediastinum (SPM) is a decisive complication reported to be associated with COVID-19. Here, we present a case of SPM in a COVID-19positive patient that was not caused by any iatrogenic or known reasons. At the time of admission, the patient was COVID-positive and distressed. He was immediately subjected to hematological and radiological investigations (chest X-ray, HRCT), which confirmed pneumomediastinum. The patient was hypoxic and hypotensive even after receiving ionotropic support. Considering the patient's critical condition, a mediastinal pigtail catheterization was performed instead of a thoracotomy, and the catheter was in situ for nine days. Arterial blood gas was monitored during the hospital stay, and supplementary oxygen therapy was provided accordingly. The patient subsequently recovered and was discharged. Hence, SPM in this COVID patient was treated by pigtail catheterization, and major surgical interventions were avoided.Copyright © 2023 LookUs Scientific. All rights reserved.
ABSTRACT
Failed intubation in obstetrics remains a topical issue, a rare but potentially devastating complication of obstetric general anaesthesia. The 2015 guidelines produced following several years of collaborative work between the Difficult Airway Society (DAS) and Obstetric Anaesthetists' Association (OAA) remain the definitive text. While deaths from failed intubation have declined significantly over 30 years, the incidence of failed intubation remains fairly constant at 1:300, with the latest studies showing a rate of 1:224. This reflects the significant decline in the use of general anaesthesia for caesarean section over the last three decades;however, it also highlights a decreased exposure for trainees to tracheal intubation in the obstetric population.
ABSTRACT
Dengue fever is common in tropical countries like India. Typically, dengue fever and dengue haemorrhagic fever is characterized by high grade fever with arthralgia, myalgia and headache. Leukopaenia, thrombocytopaenia, and fluid leak is the hallmark of dengue which normalises with recovery. However, it is very uncommon in these patients to progress to severe thrombocytosis. Authors hereby report an unusual case of dengue followed by severe reactive thrombocytosis. A 13-year-old male child was admitted with complaints of fever and headache for the past two days and vomiting for one day. There was right hypochondrium tenderness. Investigations revealed leucopaenia (total leucocyte count was 3500/μL), platelets count was 150×103/μL, haematocrit was 34.5%, and dengue virus antigen detection (NS1) was positive. Coronavirus Disease 2019 (COVID-19) Reverse Transcription-Polymerase Chain Reaction (RT-PCR) was negative. The patient was managed conservatively with intravenous fluid ringer lactate, acetaminophen, antiemetics and antacids. After 72 hours of discharge, patient came back with thrombocytosis. He was medicated on aspirin and the platelet count was monitored on a daily basis. The platelet count kept on increasing, and on 4th day it reached 1350×103/μL, but declined to normal (450×103/μL) over the next 10 days. Hence, aspirin was stopped. The patient was later discharged, and on follow-up the blood counts were normal.