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1.
JNMA J Nepal Med Assoc ; 48(173): 66-9, 2009.
Article in English | MEDLINE | ID: mdl-19529062

ABSTRACT

Down's syndrome is the most commonly encountered congenital anomaly in medical practice. These patients are of special concern to medical practice because of their associated problems with regard to respiratory, cardiovascular and other systemic problems. As these patients present for repeated surgeries like dental extraction, facial reconstruction and fixation of cervical spine, these patients pose challenges to the anesthesiologist because of their unique set of problems, namely atlantoaxial instability, small trachea, congenital heart disease and repeated chest infections due to lowered immunity. Their reactivity to inhalational anesthetics and atropine is variable. Here we present an interesting case report of a child with Down's syndrome who presented with atlantoaxial instability for MRI of cervical spine under general anesthesia.


Subject(s)
Anesthesia, General/methods , Atlanto-Axial Joint , Joint Instability/complications , Child , Down Syndrome/complications , Humans , Magnetic Resonance Imaging , Male
2.
Kathmandu Univ Med J (KUMJ) ; 6(2): 228-30, 2008.
Article in English | MEDLINE | ID: mdl-18769094

ABSTRACT

Critical illness myopathy is one of the causes for failure to wean from ventilator. Although associate factors of dyselectrolytemia is to be ruled out and other causes for failure to wean is to be ruled out before diagnosing critical illness myopathy. Several factors play role in development of this condition. Here we present a case report of a post partum patient where we had encountered failure to wean despite several attempts and at last was successfully weaned and discharged from intensive care unit.


Subject(s)
Muscle Weakness/complications , Postpartum Hemorrhage , Ventilator Weaning/adverse effects , Cesarean Section , Female , Humans , Muscle Weakness/etiology , Pregnancy , Young Adult
3.
Nepal Med Coll J ; 10(3): 199-203, 2008 Sep.
Article in English | MEDLINE | ID: mdl-19253867

ABSTRACT

Downs syndrome constitutes to be the most common chromosomal disorder. Patients with Downs's syndrome are posted for several surgeries including dental procedures and even for facial reconstruction. They are associated with several congenital anomalies in different organ system. There is also increased incidence of atlanto axial instability and risk of spinal cord injury. These children are susceptible to infection and they are also considered to be hypersensitive to the effect or atropine. These all factors modify the anesthetic implication and also anesthetic management in these cases. We have highlighted all these factors and reviewed the anesthetic implication of these child posted for several procedures under anesthesia.


Subject(s)
Anesthesia , Down Syndrome/surgery , Down Syndrome/complications , Down Syndrome/pathology , Humans
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