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Abstract Renal transplant remains the preferred therapy for end-stage renal disease (ESRD). Given the shortage of suitable donor kidneys, use of an expanded criteria donor (ECD) allows marginal kidneys to be transplanted; albeit at risk of increased graft failure due to lower nephron mass. To reduce the risk of graft failure, double kidney transplant (DKT) is advocated, with favorable outcomes. Transplant renal artery stenosis (TRAS) is one of the most common vascular complications following renal transplant. Unlike single kidney transplants, where TRAS usually presents with fluid overload, uncontrolled hypertension, and worsening kidney functions; it may be clinically silent in DKT patients since they have two functional transplanted kidneys. We hereby report a case of TRAS in a DKT patient who had 2 years of favorable clinical outcomes following successful endovascular stenting. He however recently died of COVID-19 associated pneumonitis.

Biological profiling of unknown human remains is the foremost task required in forensic/medico-legal death investigations and sex determination of such remains is an important element of biological identity of an individual. In present study, 12 anthropometric measurements were recorded on 298 Uttarkashi individuals (150 males and 148 females) between age group of 18-25 years. Majority of measurements were found to have a significant degree of sexual dimorphism among them; being highest for cubit and thumb lengths and lowest for left palm and right foot lengths (p >0.001). From Univariate discriminant function analysis, cubit length and left foot length were selected as the best variables to discriminate sex of about 80% (84% males and 76% females) 79% (84.7% males and 73.6% females) individuals, respectively. Similarly, 86% subjects could be classified to their correct sex category from all the lineal measurements (88.5% males and 87.2% females) or the hand measurements only (83.1% males and 84.6% females) from the multivariate discriminant function analysis. The results of present study can be considered an addendum to the existing population data for forensic anthropological literature.

JUSTIFICATIVA E OBJETIVOS: Siringomielia é uma condição neurológica incomum caracterizada pela presença de uma cavidade cística expansiva na medula espinhal, resultando em várias manifestações neurológicas. O objetivo deste relato de caso é destacar a segurança da anestesia geral nesse grupo de pacientes. RELATO DO CASO: Primigesta de 28 anos, com diagnóstico de siringomielia lombar, foi programada para cirurgia de cesareana (CC). A cirurgia foi realizada sob anestesia geral, sem complicações. A anestesia geral foi escolhida no caso dessa paciente para evitar qualquer manipulação do espaço subaracnoideo no bloqueio do neuroeixo central, o que poderia levar a alterações da pressão intracraniana ou agravamento de sintomas neurológicos. Foi utilizado rocurônio, considerando que evita aumento de pressão no líquido cefalorraquidiano e hipercalemia, que podem ser vistos com succinilcolina. CONCLUSÕES: A anestesia geral pode ser usada com segurança em pacientes portadores de siringomielia. Devem-se tomar precauções para evitar aumento da pressão intracraniana e o bloqueio neuromuscular deve ser monitorado.