Objective
Fast-track cardiac anesthesia (FTCA) is a technique that may improve patient access to surgery and maximize workforce utilization. However, feasibility and factors impacting FTCA implementation remain poorly explored both locally and internationally. We describe the specific intraoperative and postoperative protocols for our FTCA program, assess protocol compliance and identify reasons for FTCA failure.
Results
We tested the program in 16 patients undergoing elective cardiac surgery requiring cardiopulmonary bypass. There was 100% compliance with the FTCA protocols. Four (25%) patients successfully completed the FTCA protocol (extubated < 4 h postoperatively and discharged from the intensive care unit on the same operative day).
Pareeksha is the tool for examination in Ayurveda. The three-fold examination or trividha pareeksha includes darshana, sparshana and prashna. Udara, one among the eight serious illnesses is manifested because of low digestive fire. Here an effort is made to demonstrate the utilization of these tools of examination with a case of Jalodara (ascitis). The patient aged 60 years presented with edema in both lower limbs, severe distension of the abdomen, yellowish discoloration of conjunctiva and urine, hematemesis and weight loss. Based on trividha pareeksha, it was diagnosed as 'Jatodaka' stage of jalodara (ascitis). It was managed based on the treatment principles like agnideepana (increasing digestive fire), nitya virechana (daily purgation), shodhahara (anti inflammatory) Rasayana and external therapies. The patient showed considerable improvement in the presenting complaints. The proper knowledge of the stage or condition helped in better prognosis and planning of treatment in this case .This was possible only with ' pareeksha' or tools for examination.
had a CT and MRI of the thoracic spine that revealed a 4.8 x 3.9 cm left paraspinal cystic lesion from T3-T5 with no widening of the neural exit foraminae nor extension through them. She underwent thoracoscopic excision of the cyst with the impression being a neuroenteric/neurogenic cyst. However to our surprise histopathology showed a benign cyst of mullerian type as first described by Hattori in 2005 [2]. She was discharged day 1 postoperatively with no immediate complications and reviewed within one month with a normal chest X-ray and resolution of symptoms.
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