Background Foreign body aspiration is a life-threatening condition. Asphyxiation from inhaled foreign bodies is a leading cause of accidental death among children younger than 4 years. While early clinicians used topical anesthesia, general anesthesia became common place for the removal of aspirated objects with increased experience with the rigid bronchoscope and advances in anesthetic delivery. Inhaled anesthesia and total intravenous anesthesia are widely used for rigid bronchoscopy in children. Objective In this study, we compared sevoflurane VIMA and propofol TIVA, when used for both induction and maintenance of anesthesia in children undergoing rigid bronchoscopy for tracheal or bronchial foreign body removal. Methods This is a prospective double – blinded, randomized controlled Trial, After Approval is obtained from the research ethics committee of anaesthesia and intensive care department, Ain Shams University. Patients were randomly divided into two groups (n = 30 each). In Group VIMA, anesthesia was induced with inhalation of sevoflurane. Before induction, a closed circuit with a 1-l reservoir bag was overflowed by 8 vol % sevoflurane with 0.3 l/min fresh oxygen flow for 3 min. In Group TIVA, a bolus of 2.5 mg/kg propofol was administered over 30 seconds. Additional propofol 0.5–1 mg/kg was given as needed to deepen anesthesia. Results Our results demonstrate that compared with propofol TIVA, sevoflurane VIMA provides more stable haemo-dynamics and respiration, faster induction and recovery and higher incidence of excitement in paediatric patients undergoing tracheal/bronchial foreign body removal. Conclusion Foreign body aspiration is a life-threatening condition. Anesthetic management can be challenging, as the airway is shared with the surgeon and adequate ventilation must be maintained despite airway manipulation.
Background: Fat survival remains a challenge following fat grafting and has been a subject of debate. The key to successful fat grafting in buttock enhancement dictates familiarity with the technique, knowledge of the gluteal topography and aesthetics along with understanding of the patient's desired needs and goals. However, several areas still need to be researched. Objectives: This study aims to describe the anthropometric measurements of the Middle Eastern female buttocks and to evaluate the post-operative volume changes of structural fat grafting following gluteal enhancement procedures. Methods: This study included sixty adult healthy females. Candidates were classified into four main groups; control group (30 candidates) for measuring anthropometrics of Middle Eastern buttocks with normal BMI, and other 30 candidates were grouped into three surgical groups (10 candidates for each) according to the amount of fat grafting. Anthropometric measurements were obtained directly through patients' photos (posterior and lateral views) pre-operatively, 3 and 6 months postoperatively. Pre-operative volume of gluteal region in each quadrant was measured for the whole buttock by using the ultrasound then compared to that of 3 and 6 months post-operatively. Results: Control group (30 candidates) showed that round shape buttocks was the dominant shape. Fat survival rate of fat injected in subcutaneous plane decreased with increasing volume of fat injected, while in the intramuscular plane the survival rate the same and was not affected significantly. Conclusion and Recommendations: Round shaped buttock is the dominant shape in Middle Eastern buttock; fat survival rate is greater when injected intramuscular. We warn surgeons from trying intramuscular fat injection without anticipating problems and also without taking in consideration precautions and recommendations especially in large volume grafting. Also, we recommend authors to perform more studies in Middle Eastern buttocks for more control cases to confirm the anthropometric criteria of Middle Eastern buttocks.
Article informationBackground: Colloid cyst of the third ventricle is not uncommon. The complete excision is crucial to relieve symptoms and prevent associated completions. Previously open excision was the role. However, the endoscopic approaches gained wide acceptance. The aim of the work:The study aimed to assess the outcome of endoscopic excision of the third ventricular colloid cyst by symptoms resolution, excision extent and complications rate. Patients and Methods: This is a retrospective study that covered the duration from February 2018 to February 2021. It included 20 subjects with a third ventricular colloid cyst, who managed by an endoscopic excision. Files were reviewed for preoperative evaluation [history, clinical neurological and ophthalmological examination] and radiological investigations to identify the cyst size, site, density and enhancement and the size of the third ventricle. Postoperatively, all patients were evaluated by general and neurological clinical examination, follow up imaging study immediately [second postoperative day], at 3 and 6 postoperative months. All complications and recurrence rate were documented, and results were graded on Barrow Neurological Institute scale. Results: Males represented 60.0%; the mean age was 37.5±11.3 years. All had headache, 80.0% had blurred vision, and papilledema was recognized among 90.0%. The average size of the cyst was 17.4±2.66 mm. The total cyst removal was achieved for 85.0% and partial removal for 15.0%. Postoperative infections were developed in 20.0%. Three patients [15%] had temporary amnesia and one patient [5%] had intraventricular hemorrhage. All symptoms were resolved after surgery, except for three patients. Two of them [10%] had mild visual disturbance and one had amnesia. The recurrence of the cyst was detected in 2 patients [10%]. Conclusion:Endoscopic colloid cyst excision is an effective, safe and reliable technique with established learning curve.
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