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Imaging is essential for managing COVID-19 pneumonia. In resource-limited settings, chest radiography is the only practicable imaging modality. The Brixia radiographic scoring system, an objective method of assessing pulmonary involvement, is yet to be studied in India. (a) To study the association between the clinical severity of COVID-19 patients with their Brixia scores and, (b) to evaluate the utility of the score as a predictor for invasive ventilation. Peripheral rural hospital by Indian Armed Forces; Cross-sectional study. A thousand patients diagnosed with COVID-19 and hospitalized were classified as having a mild, moderate, and severe disease based on their least oxygen saturation (SpO2 >94: mild, between 90-94: moderate, and <90: severe) recorded. The highest Brixia score was calculated for each patient. The mean Brixia scores of the three groups were compared. The Brixia score of each intubated patient was calculated as was the mean score of all intubated patients. Statistical analysis was performed on SPSS software. Seven hundred fifty-six (756) patients were classified as mild, 104 as moderate, and 140 as severe with a mean Brixia score of 0.12, 2.35, and 10.9, with a standard deviation of 0.66, 2.98, and 2.66, respectively. The difference in means between these groups was statistically significant (p < 0.0001). The median Brixia score of 13 for the intubated patients was significantly higher than for the non-intubated. The clinical severity of the patients and their requirement for invasive ventilation correlated well with their Brixia scores. The Brixia system may be usefully incorporated into our Medicare systems. [ABSTRACT FROM AUTHOR]

Cerebral palsy, a disorder presenting with various neurological and muscular manifestations depending on severity of cerebral involvement causes variable functional limitation. This presents as a challenge when major surgeries are planned. Thoracic surgeries need detailed evaluation and optimization due to functional limitations to attain optimal outcome. We report a case of cerebral palsy who underwent thoracic surgery for posttubercular hydropneumothorax. [ABSTRACT FROM AUTHOR]

One of the most honorable acts of humanity is the donation of an organ or organs to save the lives of patients with severe diseases that necessitate organ replacement. Organs can be donated by people who are alive as well as dead. India has seen a noteworthy upsurge in organ donation following the death of the brain in recent years. There are various legal, clinical, ethical, and technical constraints implicated in the current organ donation and transplantation systems in terms of registering recipients, matching donors with recipients, removing organs, delivering organs, and transplanting organs. An end‑to‑end system is essential to ensure an impartial and competent organ donation and transplantation process. Use of blockchain technology in order to better manage organ donation and allocation can be one of the most efficient ways to remedy this situation. The article proposes blockchain‑based solution to ensure complete decentralization, security, traceability, privacy, and trustworthiness in the donation and transplantation of organs. By performing confidentiality, safety, and privacy analyses and linking our projected resolution with the prevailing one, we evaluate the performance of the suggested solution. Adopting the above-mentioned measures will lead to the creation of block chain platforms or hyper ledger fabric frameworks, streamlining organ donation and allocation processes, which will benefit India as it moves toward the digital future in health care. [ABSTRACT FROM AUTHOR]

Cardiac myxomas are extremely rare in infants, but many times are life endangering. We report a case of giant right atrial myxoma in a 7-month-old child obstructing tricuspid valve inflow, causing severe metabolic acidosis and near cardiac arrest. The child was treated with emergency surgical excision of intracardiac myxoma saving her life. [ABSTRACT FROM AUTHOR]

Introduction: Organ donation is defined as an act of giving one or more organs, without compensation, for transplantation to another person the shortage of organ donation remains one of the biggest barriers globally to the organ transplantation process. The state of Haryana has in the recent past grown leaps ahead in terms of medical tourism, but according to recent data by the MOHAN Foundation, Haryana is among the poorest performers in organ donation, more specifically cadaveric organ donation. This study aimed to assess the attitudes and awareness of organ donation in the general population of Haryana and to find out the barrier to the low organ donation numbers in the state. Materials and Methods: This study was a community-based cross-sectional study carried out among the general population of Haryana. A questionnaire was administered to 500 randomly selected people above the age of 18 in the chosen population. The data were coded and analyzed using Microsoft Excel and SPSS software. Results: A large number, 40.6% (203/500), of the participants in the survey were unaware of the term "organ donation." Only 24.5% (72/293) of participants were able to correctly identify that "organ donation" was possible from both cadavers and living human beings. 98.6% (289/293) of the participants of the survey were unaware of any legislation regarding organ donation. A dismal 27.3% (80/293) of participants were willing to donate their organs after death. Of those unwilling, 60.1% (128/213) reported that they did not want to donate because of their religion. Of those willing to donate, 28.7% (23/80) reported that they would only donate to a person of the same religion. Conclusion: The overall levels of awareness about the organ donation and acute shortage of organ donors in Haryana as well as awareness about the prevalent low rates themselves remain low. There are various religious biases leading to negative attitude toward organ donation. [ABSTRACT FROM AUTHOR]

With the rise in living standards and evolution of science, there is a rise in life expectancy world over. This demographic transition has led to a rise in older persons, increasing the dependency ratios and "demographic burden." Management of such old patients requires special considerations and understanding as aging is a physiological phenomenon in which the functional capacity of organs decreases due to degenerative changes in the structure. An important aspect to remember in Geriatric Anesthesia is that in spite of adequate compensatory mechanisms for age-related changes, there is a limitation of physiological reserve, especially in stressful circumstances like perioperative period. Geriatric patients are more sensitive to all medications and anesthetic agents. Lesser amount of drug is required to achieve the desired clinical effect, but have a prolonged effect. This elderly but well-preserved patient, possibly a case of small gut obstruction was posted for emergency laparoscopy and proceed. Seeing his age and easy friability, a well-planned preoperative assessment and optimization was done prior to wheeling him into operation theater. Administration of short-acting anesthetic drugs in titrated quantities and awareness about postoperative cognitive dysfunction (POCD) helped us to get better and faster recovery in the patient. [ABSTRACT FROM AUTHOR]

Background: Supraglottic airway devices are used for anesthesia in elective surgical procedures circumventing the need for intubation. We investigated the efficacy and safety of Baska® mask in comparison to an I-Gel® device. Methods: In this cross-sectional, observational study, we randomized 100 female patients (age 18–45 years, American Society of Anaesthesiologists grade I or II) undergoing elective short gynecological procedures into two groups, to receive ventilation with either Baska mask® (group 1, n = 50) or an I-Gel® device (group 2, n = 50). We excluded patients with obesity, short neck, and known systemic and upper airway disorders. The primary outcome was the oropharyngeal airway seal pressure, and the secondary outcomes were the ease of insertion and the complication rate. The results were analyzed using Mann–Whitney U-test and Fisher's exact test, and correlation analysis was done by Spearman's correlation test. Results: A total of 56 patients underwent dilatation and curettage, whereas the remaining had hysteroscopy in the study. The airway seal pressure achieved was higher with Baska® mask than I-Gel® device (35.8 ± 10.3 and 26.9 ± 7.5 of cm H2O, respectively; P < 0.0001). The ease of insertion (P < 0.0001) was better in group 1 and the complication rates were similar in both the groups (P > 0.05). Conclusion: Baska® mask offers a superior airway seal pressure with minimum complications in comparison to an I-Gel® device. Further studies with a large number of patients in different surgical settings are required to confirm our findings. [ABSTRACT FROM AUTHOR]

Severe hypertriglyceridemia (HTG) is associated with an increased risk of cardiovascular disease and acute pancreatitis. We report the case of a 34-year-old female admitted with complaints of recurrent pancreatitis and triglyceride (TG) levels above 995 mg/dl. The patient was started on therapeutic plasma exchange (TPE) to achieve a rapid fall (78%) in serum TG levels. We conclude that TPE is a safe and quick therapeutic treatment modality for patients with HTG-induced recurrent acute pancreatitis who fail to respond to conventional therapy. [ABSTRACT FROM AUTHOR]

Voice is one of the advanced features of natural evolution that differentiates human beings from other primates. The human voice is capable of conveying the thoughts into spoken words along with a subtle emotion to the tone. This extraordinary character of the voice in expressing multiple emotions is the gift of God to the human beings and helps in effective interpersonal communication. Voice generation involves close interaction between cerebral signals and the peripheral apparatus consisting of the larynx, vocal cords, and trachea. The human voice is susceptible to the hormonal changes throughout life right from the puberty until senescence. Thyroid, gonadal and growth hormones have tremendous impact on the structure and function of the vocal apparatus. The alteration of voice is observed even in physiological states such as puberty and menstruation. Astute clinical observers make out the changes in the voice and refer the patients for endocrine evaluation. In this review, we shall discuss the hormonal influence on the voice apparatus in normal and endocrine disorders. [ABSTRACT FROM AUTHOR]

Background: Pulmonary hypertension (PHT), if present, can be a significant cause of increased morbidity and mortality in children undergoing surgery for congenital heart diseases (CHD). Various techniques and drugs have been used perioperatively to alleviate the effects of PHT. Intravenous (IV) sildenafil is one of them and not many studies validate its clinical use.Aims and Objectives: To compare perioperative PaO 2 - FiO 2 ratio peak filling rate (PFR), systolic pulmonary artery pressure (PAP) - systolic aortic pressure (AoP) ratio, extubation time, and Intensive Care Unit (ICU) stay between two groups of children when one of them is administered IV sildenafil perioperatively during surgery for CHDs.Materials and Methods: Patients with ventricular septal defects and proven PHT, <14 years of age, all American Society of Anesthesiologists physical status III, undergoing cardiac surgery, were enrolled into two groups - Group S (IV sildenafil) and Group C (control) - over a period of 14 months, starting from October 2013. Independent t-test and Mann-Whitney U-test were used to compare the various parameters between two groups.Results: PFR was higher throughout, perioperatively, in Group S. PAP/AoP was 0.3 and 0.4 in Group S and Group C, respectively. In Group S, mean group extubation time was 7 ± 7.34 h, whereas in Group C it was 22.1 ± 10.6. Postoperative ICU stay in Group S and Group C were 42.3 ± 8.8 h and 64.4 ± 15.9 h, respectively.Conclusion: IV sildenafil, when used perioperatively, in children with CHD having PHT undergoing corrective surgery, improves not only PaO 2 - FiO 2 ratio and PAP - AoP ratio but also reduces extubation time and postoperative ICU stay. [ABSTRACT FROM AUTHOR]