A high BMI (body mass index) has been associated with higher rates of survival in patients with cardiovascular disease including patients with cerebrovascular disease, which is referred to as the obesity paradox. But the back of the coin explains the subject. In fact, body mass index does not fully reflect visceral adiposity, which is the cause of risk. In conclusion, it should be used with other parameters that show visceral adiposity to reveal the risk of obesity, metabolic syndrome and cerebrovascular disease.
{"title":"The Obesity Paradox for Stroke Patients, a Back Side of the Coin","authors":"A. Sonmezler","doi":"10.23880/accmj-16000148","DOIUrl":"https://doi.org/10.23880/accmj-16000148","url":null,"abstract":"A high BMI (body mass index) has been associated with higher rates of survival in patients with cardiovascular disease including patients with cerebrovascular disease, which is referred to as the obesity paradox. But the back of the coin explains the subject. In fact, body mass index does not fully reflect visceral adiposity, which is the cause of risk. In conclusion, it should be used with other parameters that show visceral adiposity to reveal the risk of obesity, metabolic syndrome and cerebrovascular disease.","PeriodicalId":313122,"journal":{"name":"Anaesthesia & Critical Care Medicine Journal","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127416807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amaurosis fugax refers to a transient sudden loss of vision in one or both eyes. We describe a patient of fracture shaft femur, who presented with history of 3-4 such episodes in the right eye, after sustaining a road traffic injury. On diagnostic workup, his visual acuity and fundoscopic examination was normal. He underwent an interlocking fixation procedure subsequently, which went uneventful. In the postoperative period, he developed similar recurring episodes followed by a generalized seizure. The repeat investigatory workup showed cerebral and retinal involvement with a presumptive diagnosis of fat embolism. Any intra-cardiac defects, pulmonary vascular shunts and systemic symptoms were however not evident. This case highlights the variations in the clinical presentation of fat embolism syndrome and discusses the differentiation with other look-alike conditions.
{"title":"Fat Embolism Presenting as Amaurosis Fugax: A Case Report","authors":"G. Jain","doi":"10.23880/accmj-16000164","DOIUrl":"https://doi.org/10.23880/accmj-16000164","url":null,"abstract":"Amaurosis fugax refers to a transient sudden loss of vision in one or both eyes. We describe a patient of fracture shaft femur, who presented with history of 3-4 such episodes in the right eye, after sustaining a road traffic injury. On diagnostic workup, his visual acuity and fundoscopic examination was normal. He underwent an interlocking fixation procedure subsequently, which went uneventful. In the postoperative period, he developed similar recurring episodes followed by a generalized seizure. The repeat investigatory workup showed cerebral and retinal involvement with a presumptive diagnosis of fat embolism. Any intra-cardiac defects, pulmonary vascular shunts and systemic symptoms were however not evident. This case highlights the variations in the clinical presentation of fat embolism syndrome and discusses the differentiation with other look-alike conditions.","PeriodicalId":313122,"journal":{"name":"Anaesthesia & Critical Care Medicine Journal","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121535411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The treatment of acute postoperative pain is important for modern health services. Analgesia through epidural route appears to have a brighter prospect these days. Local anesthetics like bupivacaine and ropivacaine given in epidural space have helped in successful postoperative pain management. Addition of opioids to local anesthetics has a synergistic action on analgesia. Objective: To compare analgesic efficacy of Bupivacaine and Ropivacaine in combination with Tramadol for postoperative epidural analgesia in terms of the quality of analgesia, its duration of action and side effects involved. Materials and methods: 50 patients of age 18-60 years with American Society of Anesthesiologists grade I & II, undergoing elective abdominal and lower limb surgeries were randomly allotted to each of the 2 groups. Group BT received 0.25% bupivacaine + tramadol (1 mg/kg) and group RT received 0.25% ropivacaine + tramadol (1 mg/kg) epidurally. Patients were monitored for onset, duration and quality of analgesia, cardiorespiratory stability and for any side effects or motor blockade. Results: The mean time of onset of analgesia and quality of analgesia were comparable between the two groups. The duration of action in group RT (417.20 ± 42.52 mins) was found significantly prolonged than group BT (356.00 ± 49.03 mins) with p < 0.001. Significant fall in blood pressures was seen in group BT when compared with group RT. 4 patients in group BT had motor blockade while none in group RT. There were no significant side effects in both the groups. Research Article
{"title":"Postoperative Epidural Analgesia between 0.25% Ropivacaine Plus Tramadol and 0.25% Bupivacaine Plus Tramadol in Abdominal and Lower Limb Surgeries - A Comparative Study","authors":"Shilpashri Am","doi":"10.23880/accmj-16000152","DOIUrl":"https://doi.org/10.23880/accmj-16000152","url":null,"abstract":"Background: The treatment of acute postoperative pain is important for modern health services. Analgesia through epidural route appears to have a brighter prospect these days. Local anesthetics like bupivacaine and ropivacaine given in epidural space have helped in successful postoperative pain management. Addition of opioids to local anesthetics has a synergistic action on analgesia. Objective: To compare analgesic efficacy of Bupivacaine and Ropivacaine in combination with Tramadol for postoperative epidural analgesia in terms of the quality of analgesia, its duration of action and side effects involved. Materials and methods: 50 patients of age 18-60 years with American Society of Anesthesiologists grade I & II, undergoing elective abdominal and lower limb surgeries were randomly allotted to each of the 2 groups. Group BT received 0.25% bupivacaine + tramadol (1 mg/kg) and group RT received 0.25% ropivacaine + tramadol (1 mg/kg) epidurally. Patients were monitored for onset, duration and quality of analgesia, cardiorespiratory stability and for any side effects or motor blockade. Results: The mean time of onset of analgesia and quality of analgesia were comparable between the two groups. The duration of action in group RT (417.20 ± 42.52 mins) was found significantly prolonged than group BT (356.00 ± 49.03 mins) with p < 0.001. Significant fall in blood pressures was seen in group BT when compared with group RT. 4 patients in group BT had motor blockade while none in group RT. There were no significant side effects in both the groups. Research Article","PeriodicalId":313122,"journal":{"name":"Anaesthesia & Critical Care Medicine Journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121652525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The immediate postoperative period covers the 24 hours following any surgical intervention.In order to determine the prevalence of electrolyte disturbances in the immediate postoperative period in an intensive care unit, our team assessed the presence of electrolyte disturbances in a carefully selected group of patients. Thus, 208 patients met the selection criteria. Of these, 109 (52%) were morbidly obese, and were in the postoperative period of bariatric surgery, which allowed the design of 2 subgroups of patients differentiated by the presence or absence of such pathology. Both subgroups of patients showed no statistically significant differences in prevalence of any of the evaluated electrolyte disturbances. The most prevalent electrolyte disorder in all patients participating in the study was hypomagnesemia, followed by hypocalcemia and hypokalemia. Despite the high prevalence of hypomagnesemia and hypocalcemia, no associated clinical complications were observed.
{"title":"Prevalence of Electrolyte Disorders during the Immediate Postoperative Intensive Care - The Experience of a Large Brazilian Center","authors":"Oswaldo Tolesani","doi":"10.23880/accmj-16000167","DOIUrl":"https://doi.org/10.23880/accmj-16000167","url":null,"abstract":"The immediate postoperative period covers the 24 hours following any surgical intervention.In order to determine the prevalence of electrolyte disturbances in the immediate postoperative period in an intensive care unit, our team assessed the presence of electrolyte disturbances in a carefully selected group of patients. Thus, 208 patients met the selection criteria. Of these, 109 (52%) were morbidly obese, and were in the postoperative period of bariatric surgery, which allowed the design of 2 subgroups of patients differentiated by the presence or absence of such pathology. Both subgroups of patients showed no statistically significant differences in prevalence of any of the evaluated electrolyte disturbances. The most prevalent electrolyte disorder in all patients participating in the study was hypomagnesemia, followed by hypocalcemia and hypokalemia. Despite the high prevalence of hypomagnesemia and hypocalcemia, no associated clinical complications were observed.","PeriodicalId":313122,"journal":{"name":"Anaesthesia & Critical Care Medicine Journal","volume":"307 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123068005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Percutaneous Tracheostomy in COVID-19 Patients","authors":"D. Neilipovitz","doi":"10.23880/accmj-16000173","DOIUrl":"https://doi.org/10.23880/accmj-16000173","url":null,"abstract":"","PeriodicalId":313122,"journal":{"name":"Anaesthesia & Critical Care Medicine Journal","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125375047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anesthetic Technique and Resuscitation of a 38 Weeks Pregnant Patient with Established Anaphylactic Reaction-A Mysterious Case Report","authors":"D. Banik","doi":"10.23880/accmj-16000161","DOIUrl":"https://doi.org/10.23880/accmj-16000161","url":null,"abstract":"","PeriodicalId":313122,"journal":{"name":"Anaesthesia & Critical Care Medicine Journal","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122932723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How Far could the Smoking Cessation Duration Affect Postoperative Pulmonary Complications?","authors":"Nasser M Dobal","doi":"10.23880/accmj-16000169","DOIUrl":"https://doi.org/10.23880/accmj-16000169","url":null,"abstract":"","PeriodicalId":313122,"journal":{"name":"Anaesthesia & Critical Care Medicine Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123595097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hemiballismus - Hemichorea: A Case Report","authors":"A. Sonmezler","doi":"10.23880/accmj-16000149","DOIUrl":"https://doi.org/10.23880/accmj-16000149","url":null,"abstract":"","PeriodicalId":313122,"journal":{"name":"Anaesthesia & Critical Care Medicine Journal","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131275250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Complications of Pelvic Exenteration Encountered by both Surgical Oncologists and Anesthesiologists","authors":"E. Unal","doi":"10.23880/accmj-16000159","DOIUrl":"https://doi.org/10.23880/accmj-16000159","url":null,"abstract":"","PeriodicalId":313122,"journal":{"name":"Anaesthesia & Critical Care Medicine Journal","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115597033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dexmedetomidine Versus Magnesium for Facilitating I-gel® Insertion","authors":"Yasser M Samhan","doi":"10.23880/accmj-16000147","DOIUrl":"https://doi.org/10.23880/accmj-16000147","url":null,"abstract":"","PeriodicalId":313122,"journal":{"name":"Anaesthesia & Critical Care Medicine Journal","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133480459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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