Amita Jain Gupta

Cricoid pressure with the Truview Evo2TM laryngoscope improves the glottic view

ObjectiveThe Truview Evo2™ laryngoscope blade is designed to improve glottic view. This study was designed to evaluate the effect of cricoid pressure (CP) on laryngeal view and the ease of orotracheal intubation with the Truview Evo2 laryngoscope.MethodsIn this randomized controlled trial, 50 patients (American Society of Anesthesiologists physical status I-II, aged 18 to 60xa0yr) scheduled for elective surgery were enrolled. After induction of anesthesia and muscle paralysis, laryngoscopy was performed using the Truview Evo2TM laryngoscope with the patient’s head in the neutral position. In Group 1, the percentage of glottic opening (POGO) score was evaluated first without CP, then with CP, and CP was applied for intubation. In Group 2, the POGO score was evaluated first with CP, then without CP, and no CP was applied for intubation. Time to intubation and number of attempts required for intubation were also recorded.ResultsIn 50 patients, the mean (standard deviation) POGO view obtained with the application of CP was 93% (10%) compared with 81% (19%) in patients without CP (Pxa0<xa00.01). Times to intubation were similar in the two groups: 14.2 (6.6) sec vs 14.0 (9.3) sec in Groups 1 and 2, respectively (Pxa0=xa00.924). Sixteen percent of patients in Group 1 required a second attempt at tracheal intubation, while only 4% of patients in Group 2 required a second attempt (Pxa0=xa00.162).ConclusionWhen using the Truview Evo2TM laryngoscope with the patient’s head in the neutral position, application of CP improves the glottic view. This approach is not associated with increased difficulty in intubation.RésuméObjectifLa lame du laryngoscope Truview Evo2™ est conçue de façon à améliorer la visualisation glottique. Cette étude a été mise au point afin d’évaluer l’effet de la pression cricoïdienne (PC) sur la visualisation laryngée et la facilité d’intubation orotrachéale avec le laryngoscope Truview Evo2.MéthodeDans cette étude randomisée contrôlée, 50 patients (statut physique de l’American Society of Anesthesiologists (ASA) I-II, âgés de 18 à 60 ans) devant subir une chirurgie non urgente ont été recrutés. Aprèsxa0l’induction de l’anesthésie et la curarisation, une laryngoscopie a été réalisée à l’aide du laryngoscope Truview Evo2TM, la tête du patient en position neutre. Dans le groupe 1, le score de pourcentage d’ouverture glottique (POG) a d’abord été évalué sans PC, puis avec PC, et une PC a été appliquée lors de l’intubation. Dans le groupe 2, le score POG a d’abord été évalué avec PC, puis sans PC, et aucune PC n’a été appliquée pendant l’intubation. Le temps jusqu’à intubation et le nombre de tentatives nécessaires pour réaliser l’intubation ont également été notés.RésultatsChez 50 patients, la visualisation moyenne (écart type) de la POG obtenue lors de l’application d’une PC était de 93xa0% (10xa0%) par rapport à 81xa0% (19xa0%) chez les patients sans PC (Pxa0<xa00,01). Les temps jusqu’à intubation étaient comparables dans les deux groupesxa0: 14,2 (6,6)xa0s vs 14,0 (9,3)xa0s dans les groupes 1 et 2, respectivement (Pxa0=xa00,924). Seize pour cent des patients du groupe 1 ont nécessité une deuxième tentative pour l’intubation trachéale, alors que seulement 4xa0% des patients du groupe 2 ont nécessité une deuxième tentative (Pxa0=xa00,162).ConclusionLors de l’utilisation du laryngoscope Truview Evo2TM avec la tête du patient en position neutre, l’application d’une PC améliore la visualisation glottique. Cette approche n’est pas associée à une augmentation de la difficulté d’intubation.

Facial and body blood contamination in major gynecologic surgeries

Aim:u2002 To determine the incidence of facial and body blood contamination in various major gynecologic surgeries.

Phaeohyphomycosis breast masquerading as fibroadenoma in a young teenage girl

Phaeohyphomycosis is an unusual granulomatous fungal infection, observed in immunocompromised or diabetic patients; however, it is even rarer in immunocompetent patients. Cytological findings of the same have been infrequently reported. The histopathological diagnosis or fungal culture helps in definitive diagnosis to identify the exact fungal species. Hereby, we report a rare case of invasive fungal infection in a breast lump in a young female, presenting as fibroadenoma breast. Fine needle aspiration cytology from the breast lesion showed the presence of septate acute‐angled branching fungal hyphae with focal pigmentation, morphologically suggestive of phaeohyphomycosis which was positive with fungal stains. This was later confirmed on biopsy as histopathology slides showed the presence of prominent pigmented fungal hyphae. The pus culture from needle aspirate also showed phaeohyphomycotic fungal organism delineating the species Exophiala dermatitidis. Aspiration cytology is crucial for the diagnosis of fungal infection in such cases. An appropriate diagnosis will help in early detection and treatment of such infections as these are usually associated with high morbidity and mortality.

Therapy-related acute myeloid leukemia in a patient of vaginal carcinoma post-chemoradiation with latency of 15 months: Case report

Therapy-related leukemias are haematopoietic malignancies of blood and bone marrow occurring in patients who received chemotherapy, radiotherapy or both as a treatment for various neoplastic or non-neoplastic diseases. WHO (2008) classifies therapy-related myeloid neoplasms (t-MN) into acute myeloid leukaemia, myelodysplastic syndrome, therapyrelated myelodysplastic syndrome/myeloproliferative neoplasm (Vardiman et al. 2008). Vaginal carcinoma is rare, constituting 1–3% of all malignancies of female genital tract (Gardner et al. 2015).

Filarial worm residing in ovarian papillary serous adenocarcinoma—A rare case report

Dear Editor, Filariasis is a major disabling endemic parasitic infection seen in south East Asia and India. Wuchereria bancrofti and Brugia malayi are the most common causes of filariasis in many regions in India especially in Uttar Pradesh, Bihar, Jharkhand, Andhra Pradesh, Orissa, Tamil Nadu, Kerala, and Gujarat. Incidental detection of filarial infection has been described in association with various neoplastic as well as non-neoplastic lesions. However, microfilaria coexistent with ovarian malignancy has never been reported in literature to the best of our knowledge. Herein, a case of filarial infection coexistent with ovarian papillary serous adenocarcinoma in elderly female is reported.