Background: Thymectomy for widespread Myasthenia gravis may be associated with a turbulent postoperative course especially if preoperative circulating acetylcholine receptor autoantibody levels are towering. Plasmapheresis remove these antibodies. The aim of this study was to explore the results of preoperative Plamapheresis on postoperative course after thymectomy. Material And Method This is a retrospective study at tertiary care center where 13 patients of myasthenia gravis were operated in 3 year duration (2017-2020). All patients had undergone 2 cycles of plasmapheresis before surgery. Result was evaluated postoperatively in ICU, at the time of discharge, and at follow up after 7 days, 1 month and 6 month in terms of weaning from ventilator, ICU stay, level of autoantibodies and length of hospital stay, improvement in symptoms, and mortality. Results Out of 13 patients 5 (38.46%) were male and 8 (61.54%) were female in the age range of 20 to 60 years. 6 (46.15%) were in stage IIA and 7 (53.85%) in stage IIB. Preoperative autoantibody levels were in the range of 30-50 nmol/ml. Almost total thymectomy was done in all patients. Patients were extubated with in 4-6 hrs after surgery and there was no mortality. Patients were discharged at postoperative day 4-7. Conclusion The study shows that preoperative use of plasmapheresis to reduce the autoantibody level is associated with an early extubation, early discharge and less complication after thymectomy.
Background A sudden emergence of global pandemic due to SARS- Cov -2 has changed the scenario of management of non COVID diseases. With very high infectivity rate and stormy course, this disease has made the lives of people miserable so with the health care facilities and treatment. All the medical fraternities are in the state of confusion that how to treat or not to treat the patients of illness other than the corona virus infection. We are sharing our experience of cardiac surgery at our tertiary center in lockdown and unlockdown period. Material And Method This is a retrospective study from April 2020 to November 2020. We have operated upon 232 cases in this duration. Results Out of 232 cases – Overall mortality –26, Post covid operated – 4, Number of covid positive after surgery – 3, Post covid mortality – 1 Conclusion Use of N95 mask, PPE kit or HIV KIT, with regular sanitization of hands have made possible to perform cardiac surgery in this difcult situation on the patients of cardiac illness which usually cannot wait longer.
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