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  Access statistics : Table of Contents
   2012| April-June  | Volume 6 | Issue 2  
    Online since June 8, 2012

 
 
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ORIGINAL ARTICLES
Ultrasound-guided single injection infraclavicular brachial plexus block using bupivacaine alone or combined with dexmedetomidine for pain control in upper limb surgery: A prospective randomized controlled trial
Amany S Ammar, Khaled M Mahmoud
April-June 2012, 6(2):109-114
DOI:10.4103/1658-354X.97021  PMID:22754434
Background: Dexmedetomidine, is a selective α2-adrenoceptor agonist that is used as an adjuvant mixed with local anesthetics during regional anesthesia. This study was designed to test the efficacy of adding dexmedetomidine to bupivacaine during placement of infraclavicular brachial plexus blockade (ICB). Methods: Sixty adult patients were divided into 2 equal groups of 30 subjects each. Patients in Group I received an ICB using 30 mL of 0.33% bupivacaine and Group II patients received 30 mL of 0.33% bupivacaine mixed with 0.75 μg/kg of dexmedetomidine. The following brachial plexus nerve block parameters were assessed: block success rate, sensory onset time and duration, motor block onset time and duration, analgesic pain scores using the verbal rating scale (VRS) for pain, duration of analgesia, and amount of supplemental intravenous (IV) morphine required. Results: There was a statistically significant shorter time to onset of sensory blockade (13.2 vs 19.4 min, P=0.003), longer duration of sensory block (179.4 vs 122.7 min, P=0.002), shorter onset time to achieve motor block (15.3 vs 22.2 min, P=0.003), longer duration of motor block (155.5 vs 105.7 min, P=0.002), lower VRS pain scores, prolonged analgesia (403 vs 233 min, P=0.002), and lower morphine rescue requirements for 48 h after surgery (4.9 (0-8.0) vs 13.6 mg (4.0-16.0) mg, P=0.005). All patients recovered without evidence of sensory or motor deficit. Conclusion: Adding dexmedetomidine to bupivacaine during the placement of an ICB provides: (1) enhancement of onset of sensory and motor blockade, (2) prolonged duration of analgesia, (3) increases duration of sensory and motor block, (4) yields lower VRS pain scores, and (5) reduces supplemental opioid requirements.
  7,654 610 17
CASE REPORTS
Anesthetic considerations in Leigh disease: Case report and literature review
Abdullah Sulieman Terkawi, Tariq M Wani, Khalid M Al-Shuaibi, Joseph D Tobias
April-June 2012, 6(2):181-185
DOI:10.4103/1658-354X.97037  PMID:22754450
Leigh disease is an extremely rare disorder, characterized by a progressive neurodegenerative course, with subacute necrotizing encephalomyelopathy. It usually presents in infancy with developmental delay, seizures, dysarthria, and ataxia. These patients may also develop episodes of lactic acidosis that usually lead to respiratory failure and death. Due to the rarity of the condition, the most appropriate anesthetic plan remains unclear. We present a patient with Leigh disease, who required general anesthesia. The pathogenesis of the disease is discussed and previous reports of perioperative care from the literature are reviewed.
  6,077 166 -
Anesthetic management of Shah-Waardenburg syndrome: Experience of two cases and review of literature
Uday S Ambi, ES Adarsh, Ramesh Hatti, Vijaymahantesh Samalad
April-June 2012, 6(2):172-174
DOI:10.4103/1658-354X.97034  PMID:22754447
Waardenburg syndrome (WS) is a rare autosomally inherited and genetically heterogeneous disorder of neural crest cell development. Literature regarding the anesthetic management of these cases is limited. We present 2 cases of Shah-Waardenburg syndrome and discuss them in the context of review of previously published cases.
  5,731 144 1
EDITORIALS
Dexmedetomidine: A look at a promising new avenue of use
Thomas M Halaszynski
April-June 2012, 6(2):104-106
DOI:10.4103/1658-354X.97019  PMID:22754432
  4,234 469 2
ORIGINAL ARTICLES
Early vs. late tracheostomy for the ICU patients: Experience in a referral hospital
Tareq Mahafza, Sana Batarseh, Nader Bsoul, Ehab Massad, Ibraheem Qudaisat, Abd Elmon'em Al- Layla
April-June 2012, 6(2):152-154
DOI:10.4103/1658-354X.97029  PMID:22754442
Objectives: The aim of this study is to present our experience with elective surgical tracheostomy for intensive care unit (ICU) patients who needed prolonged translaryngeal intubation in order to evaluate the proper timing and advantages of early vs. late tracheostomy and to stress upon the risks associated with delayed tracheostomy. Methods : Medical records of all patients, who underwent elective tracheostomy for prolonged intubation from September 2006 to August 2010 at Jordan University hospital, were reviewed. Results: A total of 106 patients (74 males) were included; their age ranged from 2 months to 90 yr with mean age of 46.5 yr. The mean time at which tracheostomy was done after initial tracheal intubation was 23 days (range 3-7 weeks). Trauma was the most frequent cause of ICU admission 38 (35.8%), followed by post-surgery causes 14 (13.2%). An early tracheostomy showed less complication vs late procedure. The length of stay in the ICU for patients who had an early tracheostomy was 26 days while this period for patients who had late tracheostomy was 47 days. Mortality rate among patients who had early tracheostomy was 17.1% while for late tracheostomy patients, it was 36.1%. Conclusion: Proper assessment and early tracheostomy is recommended for patients who require prolonged tracheal intubation in the ICU.
  4,269 271 2
CASE REPORTS
Anaphylactic shock during hydatid cyst surgery
Mustapha Bensghir, Salaheddine Fjouji, Najib Bouhabba, Redouane Ahtil, Alain Traore, Hicham Azendour, Nordine Drissi Kamili
April-June 2012, 6(2):161-164
DOI:10.4103/1658-354X.97031  PMID:22754444
Intraoperative anaphylactic shock is an unusual complication. Different causes can be involved. Surgery of hydatid cyst is rarely responsible. About a case report of anaphylactic shock due to hydatid cyst surgery, the authors discuss the mechanisms, principles of treatment, and prevention measures of this complication.
  3,629 234 6
ORIGINAL ARTICLES
Ultrasound guidance for central vascular access in the neonatal and pediatric intensive care unit
Al Sofyani Khouloud, Guilbert Julia, Boker Abdulaziz, Chevalier Jean Yves, Renolleau Sylvain
April-June 2012, 6(2):120-124
DOI:10.4103/1658-354X.97023  PMID:22754436
Background: Percutaneous central venous cannulation (CVC) in infants and children is a challenging procedure, and it is usually achieved with a blinded, external landmark-guided technique. Recent guidelines from the National Institute for Clinical Excellence (NICE) recommend the use of ultrasound guidance for central venous catheterization in children. The purpose of this study was to evaluate this method in a pediatric and neonatal intensive care unit, assessing the number of attempts, access time (skin to vein), incidence of complication, and the ease of use for central venous access in the neonatal age group. Methods: After approval by the local departmental ethical committee, we evaluated an ultrasound-guided method over a period of 6 months in 20 critically ill patients requiring central venous access in a pediatric intensive care unit and a neonatal intensive care unit (median age 9 (0-204) months and weight 9.3 (1.9-60) kg). Cannulation was performed after locating the puncture site with the aid of an ultrasound device (8 MHz transducer, Vividi General Electrics® Burroughs, USA) covered by a sterile sheath. Outcome measures included successful insertion rate, number of attempts, access time, and incidence of complications. Results: Cannulation of the central vein was 100% successful in all patients. The right femoral vein was preferred in 60% of the cases. The vein was entered on the first attempt in 75% of all patients, and the median number of attempts was 1. The median access time (skin to vein) for all patients was 64.5 s. No arterial punctures or hematomas occurred using the ultrasound technique. Conclusions: In a sample of critically ill patients from a pediatric and neonatal intensive care unit, ultrasound-guided CVC compared with published reports on traditional technique required fewer attempts and less time. It improved the overall success rate, minimized the occurrence of complications during vein cannulation and was easy to apply in neonatal and pediatric patients.
  3,526 247 -
EDITORIALS
Caveat lector
Abdelazeem Eldawlatly, Steven L Shafer
April-June 2012, 6(2):99-101
DOI:10.4103/1658-354X.97017  PMID:22754430
  3,491 215 1
ORIGINAL ARTICLES
Effects of addition of ketamine, fentanyl and saline with Propofol induction on hemodynamics and laryngeal mask airway insertion conditions in oral clonidine premedicated children
Tanmoy Ghatak, Dinesh Singh, Rajni Kapoor, Jaishree Bogra
April-June 2012, 6(2):140-144
DOI:10.4103/1658-354X.97027  PMID:22754440
Background: The aim of this double-blind, prospective, randomized, controlled study was to compare the effect of addition of ketamine; fentanyl and saline with propofol anesthesia on hemodynamic profile and laryngeal mask airway (LMA) insertion conditions in oral clonidine premedicated children. Methods: 180 children (age 2 - 10 years) were at first given oral clonidine (4 μg/kg) 90 minutes before operation, and then were randomly allocated to receive either ketamine 0.5 mg/kg (n=60), fentanyl 1 μg/kg (n=60) or 0.9% normal saline (n=60) before induction with propofol 3.0 mg/kg. Insertion of LMA was performed within 1 minute of injection of propofol. Heart rate and mean blood pressure were noted 1 min before induction (baseline), immediately after induction, before and after insertion of LMA for up to 3 min. Following LMA insertion, 6 subjective end points were noted-mouth opening, coughing, swallowing, patient's movement, laryngospasm, and ease of an insertion. LMA insertion summed score was prepared depending upon these variables. Results: LMA insertion summed score was nearly similar in ketamine and fentanyl group, which were significantly better than saline group (P<0.004). Mean blood pressure and heart rate were maintained in ketamine than with fentanyl or saline group. Incidence of prolonged apnea (>120 secs.) was higher in fentanyl group compared to ketamine and saline group. Conclusion: Even in oral clonidine premedicated children, addition of ketamine with propofol provides hemodynamic stability and comparable conditions for LMA insertion like fentanyl propofol with significantly less prolonged apnea.
  3,190 245 3
Prophylactic administration of haloperidol plus midazolam reduces postoperative nausea and vomiting better than using each drug alone in patients undergoing middle ear surgery
Azim Honarmand, Mohammadreza Safavi, Gholamreza Khalili, Fatemeh Mohammadnejad
April-June 2012, 6(2):145-151
DOI:10.4103/1658-354X.97028  PMID:22754441
Aims: The efficacy of using midazolam or haloperidol for prevention of postoperative nausea and vomiting (PONV) has been investigated before. The main object of the present study was to evaluate the anti-emetic effects of combining administration of intravenous haloperidol with intravenous midazolam on PONV in patients underwent middle ear surgery in comparison with using each drug alone. Methods: Study design was randomized, double-blind, placebo-controlled. 80 patients, aged 18-60 years, scheduled for middle ear surgery in Kashani Hospital Medical Center under general anesthesia were enrolled in this randomized, double-blind, placebo-controlled study. Patients were divided into 4 groups of 20 each and received haloperidol 2 mg i.v. (Group H); midazolam 2 mg i.v. (Group M); haloperidol 2 mg plus midazolam 2 mg i.v. (Group HM); saline i.v. (Group C). The incidences of PONV and complete response were evaluated at 0-2 hours after arrival to the PACU and 2-24 hours after arrival to the ward in 4 groups. Results: Patients in group HM had significantly lower incidence of PONV compared with groups H, M, and C throughout 0-24 h (P<00.5). The HM group had the lowest incidence of PONV (0-2, 2-24, and 0-24 h) and the highest incidence of complete response. Postoperative anti-emetic requirement was significantly less in group HM compared with group M or H (P<0.05). Conclusion: Combine administration of haloperidol 2 mg plus midazolam 2 mg significantly reduced PONV better than using each drug alone in patients underwent middle ear surgery under general anesthesia.
  3,007 179 2
Characterisation of aerobic bacteria isolated from endotracheal aspirate in adult patients suspected ventilator associated pneumonia in a tertiary care center in Mangalore
Ramakrishna Pai Jakribettu, Rekha Boloor
April-June 2012, 6(2):115-119
DOI:10.4103/1658-354X.97022  PMID:22754435
Background and Objectives: Despite advances in antimicrobial therapy, better supportive care modalities and use of a wide range of preventive measures, ventilator-associated pneumonia (VAP) continues to be an important cause of morbidity and mortality in intensive care unit (ICU). VAP requires a rapid diagnosis and initiation of appropriate antibiotic treatment, to prevent mortality and morbidity. Inappropriate and inadequate antibiotic treatment causes emergence of drug resistance in pathogens and poor prognosis in patients. Early detection of pathogens causing VAP helps to control their spread by administration of suitable antibiotics and proper infection control measures. The study was conducted to know the pathogens causing VAP in Fr. Muller Medical College Hospital, Mangalore, and their susceptibility pattern. Methods: A total of 100 patients, on mechanical ventilation for more than 48 h, who were suspected to have VAP were included in the study between December 2008 and November 2009. Their endotracheal aspirates (ETAs) were collected and processed. From 100 ETA, 138 isolates of count >10 5 CFU/ mL were characterized and antibiogram was determined using standard antibiotics regime. Results: Incidence of VAP was found to be 44.2% among the mechanically ventilated patients. Klebsiella pneumoniae (34%) was the most common pathogen isolated, followed by Pseudomonas aeruginosa (20%). Among them, most of the K. pneumoniae and P. aeruginosa isolates were resistant to penicillins, cephalosporins, fluoroquinolones was observed but were sensitive to piperacillin/tazobactum, cefaperazone/sulbactum, and carbapenems. All isolates were sensitive to amikacin. Interpretation and Conclusion: The present study shows prevalence of multidrug-resistant organisms in the study region. Klebsiella species was the most common pathogen isolated in ETA. Acinetobacter species were the most resistant pathogens prevailing in our ICU setup, leading to the increased mortality in the ventilated patients. Patients with chronic obstructive pulmonary disease is the most common predisposing factor for VAP in the study group.
  2,931 215 2
CASE REPORTS
Anesthetic management in children with Hurler's syndrome undergoing emergency ventriculoperitoneal shunt surgery
Nidhi Gupta, Girija Prasad Rath, Renu Bala, Bapura Kiran Reddy, Arvind Chaturvedi
April-June 2012, 6(2):178-180
DOI:10.4103/1658-354X.97036  PMID:22754449
Mucopolysaccharidoses (MPSs) are a group of lysosomal storage disorder characterized by progressive multiorgan accumulation of glycosaminoglycans. Patients with MPS I (Hurler's syndrome) present as one of the most difficult airway problems to be managed by anesthesiologists. Hydrocephalus with increased intracranial pressure is a frequent complication seen in these patients. The rarity of the syndrome accounts for the small number of case reports and anecdotal information on the intracranial manifestations of this syndrome. We describe the successful anesthetic management of 2 children with Hurler's syndrome who underwent ventriculoperitoneal shunt surgery for acute hydrocephalus.
  2,920 127 -
ORIGINAL ARTICLES
Cardioprotective effect of sevoflurane in patients with coronary artery disease undergoing vascular surgery
Ahmed S Bassuoni, Yasser M Amr
April-June 2012, 6(2):125-130
DOI:10.4103/1658-354X.97024  PMID:22754437
Objectives: The present study was conducted to evaluate the cardioprotective effect of sevoflurane compared with propofol in patients with coronary artery disease (CAD) undergoing peripheral vascular surgery; and to address the question whether a volatile anesthetic might improve cardiac outcome in these patients. Methods: One hundred twenty-six patients scheduled for elective peripheral vascular surgery were prospectively randomized to receive either sevoflurane inhalation anesthesia or total intravenous anesthesia. ST-segment monitoring was performed continuously during intra- and post-operative 48 h periods. The number of ischemic events and the cumulative duration of ischemia in each patient were recorded. Blood was sampled in all patients for the determination of cTnI. Samples were obtained before the induction of anesthesia, on admission to the ICU, and at 6, 12, 24, and 48 h after admission to the intensive care unit (ICU). Patients were followed-up during their hospital stay for any adverse cardiac events. Results: The incidence of ischemia were comparable among the groups [16 (25%) patients in sevoflurane group vs 24 (39%) patients in propofol group; P=0.126]. Duration, cumulative duration, and magnitude of ST-segment depression of ischemic events in each patient were significantly less in sevoflurane group (P=0.008, 0.048, 0.038, respectively). cTnI levels of the overall population were significantly less in sevoflurane group vs propofol group (P values <0.0001) from 6 h postoperative and onward. Meanwhile, cTnI levels at 6, 12, 24, and 48 h after admission to the ICU in patients who presented with ischemic electrocardiographic (ECG) changes were significantly lower in sevoflurane group than in the propofol group (P<0.0001, <0.0001, <0.0001, 0.0003). None of the patients presented with unstable angina, myocardial infarction, congestive heart failure, or serious arrhythmia either during ICU or hospital stay. Conclusion: Patients with CAD receiving sevoflurane for peripheral vascular surgery had significantly lower release of cardiac troponin I at 6 h postoperatively and lasting for 48 h than patients receiving propofol for the same procedure with significant decrease in duration, cumulative duration of ischemic events, and degree of ST depression in each patient.
  2,743 143 3
Real-time observations of stressful events in the operating room
AlNassar Sami, Hajjar Waseem, AlSubaie Nourah, AlHummaid Areej, AlMarshedi Afnan, Al-Shaikh Ghadeer, AlSaif Abdulaziz, Isnani Arthur
April-June 2012, 6(2):136-139
DOI:10.4103/1658-354X.97026  PMID:22754439
Aim: To identify and quantify factors causing stress in the operating room (OR) and evaluate the relationship between these factors and surgeons' stress level. Methods: This is a prospective observational study from 32 elective surgical procedures conducted in the OR of King Khalid University Hospital, Riyadh, Saudi Arabia. Before each operation, each surgeon was asked of stressors. Two interns observed 16 surgeries each, separately. The interns watched and took notes during the entire surgical procedure. During each operation, the observer recorded anxiety-inducing activities and events that occurred in real time by means of a checklist of 8 potential stressors: technical, patient problems, teamwork problems, time and management issues, distractions and interruptions, equipment problems, personal problems, and teaching. After each operation, surgeons were asked to answer the validated State-Trait Anxiety Inventory questionnaire and self-report on their stress level from the 8 sources using a scale of 1-8 (1: stress free, 8: extremely stressful). The observer also recorded perceived stress levels experienced by the surgeons during the operation. Results: One hundred ten stressors were identified. Technical problems most frequently caused stress (16.4%) and personal issues the least often (6.4%). Frequently encountered stressors (teaching and distractions/interruptions) caused less stress to the surgeons. Technical factors, teamwork, and equipment problems occurred frequently and were also a major contributor to OR stress. All patients were discharged in good health and within 1 week of surgery. Conclusion: Certain stressful factors do occur among surgeons in the OR and can increase the potential for errors. Further research is required to determine the impact of stress on performance and the outcome of surgery.
  2,723 152 2
REVIEW ARTICLE
Cooperation between research institutions and journals on research integrity cases: Guidance from the committee on publication ethics
Elizabeth Wager, Sabine Kleinert
April-June 2012, 6(2):155-160
DOI:10.4103/1658-354X.97030  PMID:22754443
Institutions and journals both have important duties relating to research and publication misconduct. Institutions are responsible for the conduct of their researchers and for encouraging a healthy research environment. Journals are responsible for the conduct of their editors, for safeguarding the research record, and for ensuring the reliability of everything they publish. It is, therefore, important for institutions and journals to communicate and collaborate effectively on cases relating to research integrity. To achieve this, we make the following recommendations. The institutions should:
  • have a research integrity officer (or office) and publish their contact details prominently
  • inform journals about cases of proven misconduct that affect the reliability or attribution of the research that they have published
  • respond to journals if they request information about issues, such as, disputed authorship, misleading reporting, competing interests, or other factors, including honest errors, that could affect the reliability of the published study
  • initiate inquiries into allegations of research misconduct or unacceptable publication practice raised by journals
  • have policies supporting a responsible research conduct and systems in place for investigating suspected research misconduct.
The journals should:
  • publish the contact details of their editor-in-chief who should act as the point of contact for questions relating to research and publication integrity
  • inform institutions if they suspect misconduct by their researchers, and provide evidence to support these concerns
  • cooperate with investigations and respond to institutions' questions about misconduct allegations
  • be prepared to issue retractions or corrections (according to the COPE guidelines on retractions) when provided with findings of misconduct arising from investigations
  • have policies for responding to institutions and other organizations that investigate cases of research misconduct.
  2,513 100 -
CASE REPORTS
Pacing to treat low cardiac output syndrome following elective aortic valve replacement
Muhammad Ishaq
April-June 2012, 6(2):169-171
DOI:10.4103/1658-354X.97033  PMID:22754446
We report a case of low cardiac output syndrome caused by dynamic left ventricular (LV) outflow obstruction after aortic valve replacement (AVR). This recognized phenomenon probably occurs more frequently than appreciated, and the author suggests that this should be considered when managing patients with severe hemodynamic instability after AVR. In addition, we also focus on the fact that invasive pacemaker systems have significant effects on cardiac output augmentation postoperatively and in long-term management of patients with LV outflow tract (LVOT) obstruction following AVR. The possible mechanisms and subsequent treatments are discussed.
  2,484 84 -
Anesthetic considerations in pemphigus vulgaris: Case series and review of literature
Abhishek Bansal, Anurag Tewari, Shuchita Garg, Anoop Kanwal
April-June 2012, 6(2):165-168
DOI:10.4103/1658-354X.97032  PMID:22754445
A case series of the anesthetic management of 4 patients with pemphigus vulgaris (PV) undergoing emergency/elective surgery is presented. PV presents serious concerns for anesthesiologist, when present, in a surgical patient but handling of these patients with care and taking all the due precautions can decrease morbidity and airway-related complications. Various clinical presentations and precautions, which should be ensured during anesthesia in patients suffering from PV, are discussed.
  2,466 91 -
ORIGINAL ARTICLES
Spectral entropy as an objective measure of sedation state in midazolam-premedicated patients
Hany A Mowafi
April-June 2012, 6(2):131-135
DOI:10.4103/1658-354X.97025  PMID:22754438
Context: Objective assessment of sedation depth is a valuable target. Spectral entropy is an anesthetic depth monitor based on the analysis of the electroencephalogram signal. Aims: To evaluate the performance of spectral entropy as an objective measure of sedation state in midazolam-premedicated patients and to correlate it with a clinically assessed sedation score. Settings and Design: This prospective double-blind placebo-controlled study was performed in King Fahd Hospital of the university. Methods: Eighty adult ASA I-II patients were randomly assigned into 4 groups. Patients were premedicated using 0.02, 0.04, or 0.06 mg/kg midazolam or saline intramuscularly. The effect of these doses on the Observer's Assessment of Alertness and Sedation (OAA/S) scale, hemodynamic variables, response entropy (RE), and state entropy (SE), was evaluated at 10, 20, and 30 min after premedication. Statistical analysis: Spearman Rank-order correlation analysis to examine the relation between OAA/S and entropy. The ability of spectral entropy to predict the depth of sedation was evaluated using Smith prediction probability. Results: Midazolam doses ≥0.04 mg/kg produced significant decreases in RE, SE, and OAA/S scores. There was a strong correlation between midazolam dose and OAA/S scale, RE, and SE since Spearman Rank R values were 0.792, 0.822, and 0.745, respectively (P<0.001). In addition, RE and SE were strong predictors of OAA/S level during midazolam sedation with no significant difference in prediction between the 2 entropy components. Conclusions: Spectral entropy is a reliable measure for the sedative premedication. It may be used to objectively assess the adequacy of midazolam premedication and to determine the dose requirement.
  2,370 113 -
CASE REPORTS
The use of botulinum toxin and epidural analgesia for the treatment of spasticity and pain in a patient with maple syrup urine disease
Abdullah M Kaki, Abeer A Arab
April-June 2012, 6(2):175-177
DOI:10.4103/1658-354X.97035  PMID:22754448
A 7-year-old boy, weighing 18 kg, was diagnosed with maple syrup urine disease (MSUD). He suffered from spasticity of the lower limbs and pain that did not respond to oral medications. Injections of botulinum toxin A (BTX-A) at 10 sites and epidural analgesia with 0.125% bupivacaine were used to treat spasticity with good results. We conclude that BTX-A combined with epidural analgesia may be a useful treatment option for incapacitating, painful spasticity related to MSUD. This treatment modality allowed a comprehensive rehabilitation program to be completed and it lasted longer than 9 months.
  2,185 84 -
EDITORIALS
Why has the committee on publication ethics developed guidelines for cooperation between journals and research institutions?
Elizabeth Wager
April-June 2012, 6(2):102-103
DOI:10.4103/1658-354X.97018  PMID:22754431
  1,859 132 -
LETTERS TO EDITOR
Severe unilateral bronchospasm due to inadequate anesthetic depth: A case report and review of literature
Rohini Bhat Pai, Harihar V Hegde, V Srikanth, P Raghavendra Rao
April-June 2012, 6(2):186-188
DOI:10.4103/1658-354X.97039  PMID:22754452
  1,848 105 -
EDITORIALS
Non-cardiac surgery and volatile agents - Back to the future
G Landoni, L Cabrini
April-June 2012, 6(2):107-108
DOI:10.4103/1658-354X.97020  PMID:22754433
  1,791 118 -
LETTERS TO EDITOR
Ogilvie's syndrome
Vipul D Yagnik
April-June 2012, 6(2):186-186
DOI:10.4103/1658-354X.97038  PMID:22754451
  1,813 85 -
Plagiarism: Intention and diagnostic criteria
Karen Shashok
April-June 2012, 6(2):188-188
DOI:10.4103/1658-354X.97040  PMID:22754453
  1,635 105 -
Severe bradycardia during suprasellar meningioma resection
Tumul Chowdhury, Sachidanand Jee Bharati, Keshav Goyal, Navdeep Sokhal
April-June 2012, 6(2):189-189
DOI:10.4103/1658-354X.97041  PMID:22754454
  1,577 85 -
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