Invasive aspergillosis usually affects immune-compromised patients and is common in diabetics. Proptosis, visual loss and ophthalmoplegia due to intra-orbital extension are common presentations. Three out of five patients in our series were immune-compromised. All the patients had visual loss and three patients presented with unilateral blindness. Three patients were treated by surgical debridement followed by Amphotericin B therapy. Two patients who had intra-cranial extension of the disease died during the treatment. Only one patient had improvement in vision following the treatment. High index of suspicion in immune-compromised patients, early diagnosis and prompt aggressive treatment is required to achieve clinical cure.
Background and Aims:
Airway management in patients with cervical spine pathology is challenging. The aim of the study was to evaluate GlideScope (GVL) and D blade of C-MAC (CMAC-D) using manual inline axial stabilisation (MIAS) for tracheal intubation in patients with cervical spine injury/pathology.
Methods:
This is a randomised, single-blind, hospital-based study. After obtaining informed consent, 54 patients with cervical spine pathology/injury were grouped into GVL group or CMAC-D group, (
n
= 27 each) based on computer-generated random number table. Preoperative airway difficulty score (ADS) was calculated. The primary outcome of the study was intubation difficulty score (IDS) and the secondary outcomes included total time taken to secure airway, failure to intubate, haemodynamic parameters and adverse events. Data was represented in the form of number (%) or mean and standard deviation and median and interquartile range as appropriate. Chi square test was used for analysing IDS.
Results:
The mean ± SD of IDS of the CMAC-D and GVL groups were 0.04 ± 0.2 (0.04–0.11) and 0.19 ± 0.40 (0.03–0.34), respectively, (
P
value = 0.096). The number (%) of patients with IDS > 0 was 1 (3.7) in CMAC-D and 5 (18.5) in GVL group, (
P
value = 0.192). Demographic data, ADS, Cormack–Lehane grading, success rate, time of tracheal intubation, type of surgeries, haemodynamic parameters and post-operative complications were similar in both the groups.
Conclusion:
Both GVL and CMAC-D with MIAS are equally efficacious in tracheal intubation in cervical spine injury/pathology patients without other difficult airway management criteria.
Desmoplastic infantile astrocytomas (DIA) are huge cerebral masses with cystic and solid components in infants with a benign course. Less than 50 cases of have been reported in the literature and most of the cases are children below 24 months. We are presenting a rare case of DIA which presented at the age of 4 years with vomiting and headache in neurosurgical OPD. He was diagnosed with a huge left temporal parietal tumor with midline shift which on histopathological examination was confirmed as DIA. Patient was operated and had good recovery and was followed up for two years.
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