Pub Date : 2022-01-01DOI: 10.4103/mamcjms.mamcjms_27_21
D. Sabat, Prerna Kukreti
The authors describe the case of an adult male patient with psychosis developed fractures of neck femur of both sides sequentially at a year interval following trivial trauma. In addition, the patient was found to have hyperthyroidism. The rare presentation, possible complex etiopathogenesis for the problem and difficulties in treatment are discussed.
{"title":"Sequential Fracture of Neck of Femur of Both Sides in a Patient with Psychosis: A Diagnostic Dilemma","authors":"D. Sabat, Prerna Kukreti","doi":"10.4103/mamcjms.mamcjms_27_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_27_21","url":null,"abstract":"The authors describe the case of an adult male patient with psychosis developed fractures of neck femur of both sides sequentially at a year interval following trivial trauma. In addition, the patient was found to have hyperthyroidism. The rare presentation, possible complex etiopathogenesis for the problem and difficulties in treatment are discussed.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46769893","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}
Pub Date : 2022-01-01DOI: 10.4103/mamcjms.mamcjms_34_21
D. Gahlot, B. Wadhwa, K. Saxena
Obstetric patients offer specific anesthesia concerns and associated coronavirus disease 2019 (COVID-19) infection makes the condition more challenging. We describe anesthetic management and difficulties encountered in a parturient with multiple comorbid conditions who came for an emergency caesarean section (CS). A 32-year-old morbid obese COVID-positive female G2P1L1 at 36 weeks gestation with previous LSCS, gestational hypertension, and diabetes presented for emergency CS in view of fetal distress. She had a respiratory rate of 24 to 28/minute maintaining a saturation of 94% to 95% on oxygen at 6 to 8 L/minute. Airway examination revealed mouth opening = 2.5 cm, Mallampati classification III, neck circumference 40 cm, temporomandibular distance 3.5 cm. Surgical duration was unusually prolonged and was successfully managed with total intravenous anesthesia (TIVA) as an adjuvant to subarachnoid block. We successfully managed an emergency CS of a morbidly obese parturient with COVID-19 infection using TIVA as a rescue anesthesia to central neuraxial block, avoiding conversion to general anesthesia, minimizing aerosolization and associated risk.
{"title":"Use of TIVA as an Adjuvant to SAB in a COVID-19-positive Parturient with Morbid Obesity Posted for Emergency Caesarean Section − A Case Report","authors":"D. Gahlot, B. Wadhwa, K. Saxena","doi":"10.4103/mamcjms.mamcjms_34_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_34_21","url":null,"abstract":"Obstetric patients offer specific anesthesia concerns and associated coronavirus disease 2019 (COVID-19) infection makes the condition more challenging. We describe anesthetic management and difficulties encountered in a parturient with multiple comorbid conditions who came for an emergency caesarean section (CS). A 32-year-old morbid obese COVID-positive female G2P1L1 at 36 weeks gestation with previous LSCS, gestational hypertension, and diabetes presented for emergency CS in view of fetal distress. She had a respiratory rate of 24 to 28/minute maintaining a saturation of 94% to 95% on oxygen at 6 to 8 L/minute. Airway examination revealed mouth opening = 2.5 cm, Mallampati classification III, neck circumference 40 cm, temporomandibular distance 3.5 cm. Surgical duration was unusually prolonged and was successfully managed with total intravenous anesthesia (TIVA) as an adjuvant to subarachnoid block. We successfully managed an emergency CS of a morbidly obese parturient with COVID-19 infection using TIVA as a rescue anesthesia to central neuraxial block, avoiding conversion to general anesthesia, minimizing aerosolization and associated risk.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49636267","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}
Pub Date : 2022-01-01DOI: 10.4103/mamcjms.mamcjms_3_21
M. Manohar, B. Wadhwa, K. Saxena, D. Gahlot
A 12-year-old female, diagnosed case of Down phenotype with Moyamoya disease (MMD) was posted for internal fixation of compound fracture shaft of femur. Preanesthetic evaluation revealed history of acute URI, abnormal body movements, left hemiparesis and mental retardation. Patient was managed under general anesthesia with proseal LMA and caudal epidural was administered for adequate analgesia in the perioperative period. The goal of anaesthetic management in a case of MMD is to maintain the balance between cerebral metabolic oxygen consumption rate (CMRO2) and cerebral blood flow (CBF) in order to prevent any neurologic morbidity. Though there is no ideal anaesthetic agent in MMD, the anaesthetic technique should ensure normotension, normocapnia and normothermia in the perioperative period. To our knowledge regional analgesia has not been used in the pediatric orthopedic surgeries in patients diagnosed with Moya moya. The technique of general anaesthesia supplemented with caudal epidural analgesia ensures that all the anesthetic goals are met adequately and the precarious cerebral circulation in moya moya patient is not compromised.
{"title":"Anesthetic Management in Pediatric Patient with Moyamoya Disease in Orthopaedic Surgery: “Managing the Precarious Circulation”","authors":"M. Manohar, B. Wadhwa, K. Saxena, D. Gahlot","doi":"10.4103/mamcjms.mamcjms_3_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_3_21","url":null,"abstract":"A 12-year-old female, diagnosed case of Down phenotype with Moyamoya disease (MMD) was posted for internal fixation of compound fracture shaft of femur. Preanesthetic evaluation revealed history of acute URI, abnormal body movements, left hemiparesis and mental retardation. Patient was managed under general anesthesia with proseal LMA and caudal epidural was administered for adequate analgesia in the perioperative period. The goal of anaesthetic management in a case of MMD is to maintain the balance between cerebral metabolic oxygen consumption rate (CMRO2) and cerebral blood flow (CBF) in order to prevent any neurologic morbidity. Though there is no ideal anaesthetic agent in MMD, the anaesthetic technique should ensure normotension, normocapnia and normothermia in the perioperative period. To our knowledge regional analgesia has not been used in the pediatric orthopedic surgeries in patients diagnosed with Moya moya. The technique of general anaesthesia supplemented with caudal epidural analgesia ensures that all the anesthetic goals are met adequately and the precarious cerebral circulation in moya moya patient is not compromised.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46539098","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}
Pub Date : 2021-05-01DOI: 10.4103/MAMCJMS.MAMCJMS_94_20
Shreya Sood, Arpita Gupta
{"title":"Mental Health Tool-Kit for Healthcare Professionals","authors":"Shreya Sood, Arpita Gupta","doi":"10.4103/MAMCJMS.MAMCJMS_94_20","DOIUrl":"https://doi.org/10.4103/MAMCJMS.MAMCJMS_94_20","url":null,"abstract":"","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46711043","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}
Pub Date : 2021-05-01DOI: 10.4103/mamcjms.mamcjms_78_21
Sharad Joshi, Nitesh Tayal, Ankit Bhatia
Novel coronavirus disease 2019 (COVID-19) has emerged as a rapidly spreading viral illness throughout the world. Majority of patients develop pulmonary manifestations. Involvement of extrapulmonary site is rare. We here present a rare case of massive pericardial effusion as a presenting feature of COVID-19 infection.
{"title":"A Rare Case of COVID-19 Infection Presenting as Massive Pericardial Effusion in Young Adult","authors":"Sharad Joshi, Nitesh Tayal, Ankit Bhatia","doi":"10.4103/mamcjms.mamcjms_78_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_78_21","url":null,"abstract":"Novel coronavirus disease 2019 (COVID-19) has emerged as a rapidly spreading viral illness throughout the world. Majority of patients develop pulmonary manifestations. Involvement of extrapulmonary site is rare. We here present a rare case of massive pericardial effusion as a presenting feature of COVID-19 infection.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42631098","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}
Pub Date : 2021-05-01DOI: 10.4103/mamcjms.mamcjms_118_20
S. Arora, A. Sankaran, A. Dhal
The etiology of avascular necrosis of the lunate (Kienbock disease) remains unclear despite long clinical experience. Very rarely, it may be associated with carpal instability. We describe a case of 45-year-old female who had Kienbock disease with associated volar intercalated segment instability, detailing how the radiographic features can often cause a dilemma in the staging and management of this enigmatic problem.
{"title":"Kienbock’s Disease with Volar Intercalated Segment Instability: A Therapeutic Dilemma","authors":"S. Arora, A. Sankaran, A. Dhal","doi":"10.4103/mamcjms.mamcjms_118_20","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_118_20","url":null,"abstract":"The etiology of avascular necrosis of the lunate (Kienbock disease) remains unclear despite long clinical experience. Very rarely, it may be associated with carpal instability. We describe a case of 45-year-old female who had Kienbock disease with associated volar intercalated segment instability, detailing how the radiographic features can often cause a dilemma in the staging and management of this enigmatic problem.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47704759","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}
Pub Date : 2021-05-01DOI: 10.4103/mamcjms.mamcjms_106_20
Vaibhav Aggarwal
Every year thousands of domestic and international medical graduates apply for a residency spot in the United States. This communication is an effort to qualitatively measure and describe the impact of the coronavirus disease 2019 (COVID-19) pandemic on the United States residency match application process. This communication tries to perceive a medical graduate who faces the challenges of being a health worker and an examinee at the same time. It is meant for international United States Medical Licensing Examination (USMLE) aspirants to apprise them of the changes that have taken place in the USMLE examinations as a result of the COVID-19 pandemic and advise on how to overcome the difficulties.
{"title":"How Do Residency Match Applicants Fight Battle Against COVID-19 Storm?","authors":"Vaibhav Aggarwal","doi":"10.4103/mamcjms.mamcjms_106_20","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_106_20","url":null,"abstract":"Every year thousands of domestic and international medical graduates apply for a residency spot in the United States. This communication is an effort to qualitatively measure and describe the impact of the coronavirus disease 2019 (COVID-19) pandemic on the United States residency match application process. This communication tries to perceive a medical graduate who faces the challenges of being a health worker and an examinee at the same time. It is meant for international United States Medical Licensing Examination (USMLE) aspirants to apprise them of the changes that have taken place in the USMLE examinations as a result of the COVID-19 pandemic and advise on how to overcome the difficulties.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45415032","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}
Pub Date : 2021-05-01DOI: 10.4103/MAMCJMS.MAMCJMS_67_20
N. Murthy, S. Umesh, G. Ravindran
Context: Extrapulmonary tuberculosis (EPTB) presentation can be unusual, and the diagnosis may often be challenging when associated with HIV. Aims: This study was conducted to find out the pattern of newly diagnosed EPTB in hospitalized patients, the diagnostic modalities used to arrive at the diagnosis, frequency of HIV positivity among them, and its association with CD4 counts. Settings and Design: All patients newly diagnosed to have EPTB admitted in a tertiary care medical college hospital in various departments over 1 year were included. Methods and Materials: Clinical presentation, comorbidities, and investigations done to arrive at diagnosis of EPTB were recorded. They were classified based on the affected site. HIV was tested for all patients, and CD4 counts in positive patients. Results: A total of 230 patients were newly diagnosed to have EPTB. The median age was 35 years (IQR 29–45), and the proportion of males was 127 (55%). Imaging was used alone in 47 (20%) patients and in combination with cytology or biopsy in 133 (57.8%) patients to establish the diagnosis. Pleural effusion, 50 (21.7%) patients, peripheral lymph node TB (LNTB), 44 (19.1%) patients, and CNS TB, 37 (16.1%) patients, were the most common forms. HIV was associated in 61 (26.5%) patients and diabetes in 27 (11.5%) patients. Both diseases influenced the presentation of EPTB. There was an association between HIV positivity and type of EPTB with peripheral LNTB being the most common in HIV patients. High CD4 counts were associated with pleural effusion and low counts with disseminated forms. Statistical Analysis Used: chi-square, ANOVA, and Student t test. Conclusion: The pattern of EPTB changes with HIV and vigilance is required to detect severe and disseminated forms of EPTB with lower CD4 counts.
{"title":"Extrapulmonary Tuberculosis and Its Association with HIV in Patients Hospitalized in a Tertiary Care Center: A Cross-Sectional Study","authors":"N. Murthy, S. Umesh, G. Ravindran","doi":"10.4103/MAMCJMS.MAMCJMS_67_20","DOIUrl":"https://doi.org/10.4103/MAMCJMS.MAMCJMS_67_20","url":null,"abstract":"Context: Extrapulmonary tuberculosis (EPTB) presentation can be unusual, and the diagnosis may often be challenging when associated with HIV. Aims: This study was conducted to find out the pattern of newly diagnosed EPTB in hospitalized patients, the diagnostic modalities used to arrive at the diagnosis, frequency of HIV positivity among them, and its association with CD4 counts. Settings and Design: All patients newly diagnosed to have EPTB admitted in a tertiary care medical college hospital in various departments over 1 year were included. Methods and Materials: Clinical presentation, comorbidities, and investigations done to arrive at diagnosis of EPTB were recorded. They were classified based on the affected site. HIV was tested for all patients, and CD4 counts in positive patients. Results: A total of 230 patients were newly diagnosed to have EPTB. The median age was 35 years (IQR 29–45), and the proportion of males was 127 (55%). Imaging was used alone in 47 (20%) patients and in combination with cytology or biopsy in 133 (57.8%) patients to establish the diagnosis. Pleural effusion, 50 (21.7%) patients, peripheral lymph node TB (LNTB), 44 (19.1%) patients, and CNS TB, 37 (16.1%) patients, were the most common forms. HIV was associated in 61 (26.5%) patients and diabetes in 27 (11.5%) patients. Both diseases influenced the presentation of EPTB. There was an association between HIV positivity and type of EPTB with peripheral LNTB being the most common in HIV patients. High CD4 counts were associated with pleural effusion and low counts with disseminated forms. Statistical Analysis Used: chi-square, ANOVA, and Student t test. Conclusion: The pattern of EPTB changes with HIV and vigilance is required to detect severe and disseminated forms of EPTB with lower CD4 counts.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48833572","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}
Pub Date : 2021-05-01DOI: 10.4103/mamcjms.mamcjms_77_21
Romit Saxena, Muthu Rajanagam, U. Jhamb, V. Manchanda, S. Saxena, Pallavi
Background: Coronavirus disease 2019 (COVID-19) pandemic mounts an ever increasing challenge on healthcare resources. Ivermectin shows promise in in vitro studies on coronavirus, but there are few prospective trials on currently approved dosage recommendation for the treatment of COVID-19. Aims: To study the virologic and clinical recovery after single-dose ivermectin, given within first 5 days of symptom onset. Settings and design: Prospective, open-labeled, randomized controlled trial. Patients were recruited in between August 30, 2020, and November 6, 2020, at a single referral center for patients with COVID. Materials and methods: The study participants included patients presenting with severe acute respiratory syndrome coronavirus 2 infection. The patients were randomized to receive a single-dose ivermectin, 0.2 mg/kg in the treatment group (TG). Both groups [TG and control group (CG)], continued to receive standard treatment. Results: The recruited cohort was comparable in the two arms of the study, except age and height. There was no statistically significant difference in virologic clearance between the two arms (percentage COVID positive day 7: TG: 34.2% vs. CG: 52.6%, P = 0.165). Conclusion: Our study shows that after administration of single dose of currently approved doses of ivermectin (0.2 mg/kg), there does not exist a significant virologic or clinical recovery in COVID-19 disease.
{"title":"Efficacy of Single-Dose Ivermectin on Virologic and Clinical Recovery in COVID-19: A Randomized Controlled Trial","authors":"Romit Saxena, Muthu Rajanagam, U. Jhamb, V. Manchanda, S. Saxena, Pallavi","doi":"10.4103/mamcjms.mamcjms_77_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_77_21","url":null,"abstract":"Background: Coronavirus disease 2019 (COVID-19) pandemic mounts an ever increasing challenge on healthcare resources. Ivermectin shows promise in in vitro studies on coronavirus, but there are few prospective trials on currently approved dosage recommendation for the treatment of COVID-19. Aims: To study the virologic and clinical recovery after single-dose ivermectin, given within first 5 days of symptom onset. Settings and design: Prospective, open-labeled, randomized controlled trial. Patients were recruited in between August 30, 2020, and November 6, 2020, at a single referral center for patients with COVID. Materials and methods: The study participants included patients presenting with severe acute respiratory syndrome coronavirus 2 infection. The patients were randomized to receive a single-dose ivermectin, 0.2 mg/kg in the treatment group (TG). Both groups [TG and control group (CG)], continued to receive standard treatment. Results: The recruited cohort was comparable in the two arms of the study, except age and height. There was no statistically significant difference in virologic clearance between the two arms (percentage COVID positive day 7: TG: 34.2% vs. CG: 52.6%, P = 0.165). Conclusion: Our study shows that after administration of single dose of currently approved doses of ivermectin (0.2 mg/kg), there does not exist a significant virologic or clinical recovery in COVID-19 disease.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47189852","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}
Pub Date : 2021-05-01DOI: 10.4103/mamcjms.mamcjms_71_21
S. Wadhawan, F. Husain, M. Agarwal
Rhino-orbital-cerebral mucormycosis (ROCM) is an aggressive, lethal, angioinvasive fungal infection that has presented as an opportunistic infection in the backdrop of a highly infectious and severe second coronavirus disease 2019 (COVID-19) wave in India. The dominant delta strain during the second wave led to an unprecedented rise in hospital admissions with moderate to severe COVID-19 illness. A working staging system is helpful in triaging these patients to prioritize surgical debridement and liposomal amphotericin B induction therapy. The evaluation and optimization of post-COVID-19 sequelae becomes a cornerstone in achieving a favorable perioperative outcome. As anesthesiologists, we share our experience in managing this novel subset of patients. Post-COVID-19 sequelae with a prothrombotic state and multisystem involvement, challenging and shared airway, and amphotericin B-related complications are being the key concerns.
{"title":"The New Normal Anesthesiologist and the Challenging Post-COVID-19 Mucormycosis Patients − Our Experience","authors":"S. Wadhawan, F. Husain, M. Agarwal","doi":"10.4103/mamcjms.mamcjms_71_21","DOIUrl":"https://doi.org/10.4103/mamcjms.mamcjms_71_21","url":null,"abstract":"Rhino-orbital-cerebral mucormycosis (ROCM) is an aggressive, lethal, angioinvasive fungal infection that has presented as an opportunistic infection in the backdrop of a highly infectious and severe second coronavirus disease 2019 (COVID-19) wave in India. The dominant delta strain during the second wave led to an unprecedented rise in hospital admissions with moderate to severe COVID-19 illness. A working staging system is helpful in triaging these patients to prioritize surgical debridement and liposomal amphotericin B induction therapy. The evaluation and optimization of post-COVID-19 sequelae becomes a cornerstone in achieving a favorable perioperative outcome. As anesthesiologists, we share our experience in managing this novel subset of patients. Post-COVID-19 sequelae with a prothrombotic state and multisystem involvement, challenging and shared airway, and amphotericin B-related complications are being the key concerns.","PeriodicalId":32900,"journal":{"name":"MAMC Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41432971","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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