Pulmonary embolism in an ESRD patient following minimal venotomy and milking for salvage of dysfunctional autogenous arteriovenous fistula.

Pulmonary embolism can be a complication following an attempted salvage of a dysfuctional arteriovenous fistula (AVF). We report a case of bilateral pulmonary embolism in a patient with underlying pericardial effusion who, following minimal venotomy and milking of the AVF, developed sudden and significant respiratory distress, and later improved.

Recurrent Ischemic Stroke in a Patient with Atrial Myxoma: A Case Report.

Cardiac myxoma is an infrequent but curable cause of ischemic stroke. There are no guidelines addressing the timing of surgery to excise the tumour or for the use of thrombolysis or thrombectomy. We present a case with an ischemic stroke which was diagnosed to have atrial myxoma. She was planned for surgical excision of the tumour but suffered from a second ischemic stroke while awaiting surgery. This article aims to highlight vital aspects of this rare phenomenon and discuss the prospects of the timing of surgery and neurosurgical intervention. The importance of a proper cardiac evaluation in all cases of stroke is highlighted. Keywords: cardiac tumour; myxoma; cardiac surgery; ischemic stroke.

Steroid Stewardship in COVID-19.

Corticosteroids have transformed clinical practice in COVID-19 following the publication of the results of the RECOVERY trial. Despite available evidence, there is considerable disparity among physicians in the dose and duration of steroids they prescribe. Steroids have a fragile affiliation in clinical practice with the benefits frequently accompanied by distressing adverse effects. An institutional steroid stewardship program can help all physicians take advantage of what is the only proven therapy of benefit in this global crisis while avoiding its overuse and the numerous adverse effects associated with it. Keywords: COVID-19; corticosteroids; RECOVERY trial; steroid stewardship.

Total Intravenous Anaesthesia for Fibre Optic-Aided Nasal Endotracheal Intubation in a Toddler with Anticipated Difficult Mask Ventilation.

Paediatric airway tumours can prove to be quite challenging for anaesthesiologists. We attempted to secure airway in a toddler with a large tongue haemangioma using total intravenous anaesthesia (TIVA) with dexmedetomidine and propofol while preserving spontaneous ventilation.