Raquel d’ Espiney, Jacek Jablonski, Michal Brys and Juan F Martin Lazaro*

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Background: Humidified high flow nasal cannula (HFNC) has been shown to be an effective respiratory support therapy in both primary and post-extubation patients with Type 1 respiratory failure (T1RF). Clinical outcomes using HFNC in patients with hypercapnic respiratory failure or Type 2 respiratory failure (T2RF) are less well understood as research to date has frequently excluded hypercapnic patients. However, there is growing evidence that suggests HFNC could be beneficial in patients with T2RF.Aims: To describe the outcome of patients with T2RF who received primary HFNC and to elaborate a safe algorithm for its use.Methods: We conducted a retrospective observational study on the use of HFNC as a primary treatment in 102 (n=102) consecutive subjects admitted to the Intensive Care Unit (ICU) from August 2015 to June 2017. Vital signs an..... ReadMore

Ahmed A Khalifa FRCS*

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Total knee arthroplasty (TKA) considered to be one of the most common orthopedic surgical procedures performed worldwide. Anesthesia techniques had been developed as part of the development of the TKA surgical techniques over the past decades. Regional anesthesia started to take the upper hand as the dominant form of anesthesia from the general anesthesia which was considered as the standard practice in the past. It had been shown in many studies the probability of reducing intra-operative blood loss, length of hospital stays, patient outcomes and mortality rates when regional anesthesia was used instead of general anesthesia...... ReadMore

Saloua Khalfaoui*

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The pain of the shoulder at the hemiplegic is one of the main complications arisen post-stroke. The causes are multiple and in most of the cases, they are associated with pre-existent or added risk factors; where from the interest of a premature diagnostic coverage with implementation of the means of prevention and curative treatment to favor the neurological recovery...... ReadMore

Aamir Siddiqui*

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Vitamin B12 deficiency usually mimics megaloblastic anemia, pancytopenia, neurological symptoms and, rarely, hemolytic anemia. This report describes a case with symptoms of apathy and findings suggestive of severe hemolytic anemia, diagnosed with vitamin B12 deficiency. Haemolysis is a rare hematological finding in cases of B12 deficiency, and descriptions of a nutritional vitamin B12 deficiency, without evidence of pernicious anaemia, causing haemolysis, are even scarcer, and this paper was intended to draw physicians� attention to this rare form of presentation...... ReadMore

Alaa Ali M Elzohry*

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Background: Major abdominal surgeries still the main line of treatment for upper abdominal malignancies and these surgeries induce severe postoperative pain with different types either somatic or visceral. If such pain not controlled, may cause various organ dysfunctions and prolong both hospital and ICU stay. So, an appropriate pain therapy to those patients with least complications must be applicated.Objective: To compare analgesic efficacy of intraperitoneal irrigation of fentanyl added to levo-bupivacaine versus patient controlled intravenous analgesia in patients undergoing major abdominal cancer surgeries. Methods: 120 patients (ASA II-III) of either sex were scheduled for elective upper abdominal cancer surgeries. Patients were randomly allocated into three groups (40 patients each), to receive: post-operative PC..... ReadMore

Siccandar Jeelani*

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Corticosteroids are used in the management of Oral and maxillofacial lesions because of their anti-inflammatory and immunosuppressive effects. The anti-inflammatory and immunosuppressive effects of steroids reflect them as the magic drug of choice. However, the potential risks have to be taken into judicious consideration before prescribing corticosteroids because they are a double-edged sword...... ReadMore

Juan F Martin Lazaro*, Marc Brown, Emily Gould, Johann Grundlingh, Michal Brys Ieva Norkiene, Joaquim Cevallos, James Napier, Khyati Lad, Jacek Jablonski

DOI : 10.32474/GJAPM.2019.01.000111

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Removal of serum toxins using haemofiltration with human albumin has been demonstrated to be a useful option for the treatment of a patient following the ingestion of unknown substance. Here, a case is described in which a patient presented with symptoms of neuroleptic malignant syndrome after ingesting an unknown Nigerian herbal remedy. Albumin enhanced continuous veno-venous haemodialysis has been previously used for intoxications. When combining continuous renal replacement therapy with albumin, the toxins are bound to the larger molecule which prevents the toxins moving through the filter; allowing for clearance from the blood. We suggest that Intensive Care Units should consider basic tools, such as detox haemofiltration when an unknown poison is suspected..... ReadMore

Seun Ayoade*

DOI : 10.32474/GJAPM.2019.01.000110

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The cellular dust hypothesis states that all life (including human life) and the physical universe/entire cosmos came to be as a result of the activities/chemical reactions carried out by indestructible microscopic (maximum size 500 nanometre) entities called microzymas [1]. Discovered in the mid-1800s, alternative terms for macerozymes include cellular dust, protits, bions, scintillating corpuscles, siphonospora polymorpha etc [2]. These microzymas are found in all living things and continue to exist when living things perish. They are immortal and are considered to be the basic unit of life/living thing according to the Terrain and Germ Terrain Duality theories of disease [3]...... ReadMore

Igor Klepikov*

DOI : 10.32474/GJAPM.2019.01.000109

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The question raised in the title of this letter is a natural consequence of the findings and conclusions that have been growing steadily in recent years regarding the results of treatment for acute pneumonia (АР). If you look at the publications of recent years in this field of medicine, it turns out that one of the main obstacles to progress in improving the results of treatment of this disease is the lack of appropriate methods for determining the pathogen. Thus, the lack of timely diagnostic information about the etiology of the disease excludes the possibility of targeted antibiotic therapy. In recent years, such regrets have become more and more relevant, playing the role of the main explanation for treatment failures..... ReadMore

Naomi Ujino, Junko Nakahira*, Shoko Nakano, Toshiyuki Sawai and Toshiaki Minami

DOI : 10.32474/GJAPM.2019.01.000108

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Background: Over-insertion of a pulmonary artery catheter (PAC) can cause serious complications, such as pulmonary embolism and pulmonary artery rupture. Careful management is essential. Methods: This study investigated relationships between patient parameters and appropriate PAC insertion length. A function on the chest X-ray display was used to measure the curve. In Study 1, we investigated concordance using intraclass concordance coincidence (ICC) between recorded insertion length of the PAC and actual inserted length. We reviewed recorded insertion data from patients� anesthesia records and measured actual inserted length. In Study 2, we measured and estimated the appropriate insertion length using chest X-rays taken just after surgery. Multiple logistic regression was performed to investigate relati..... ReadMore

Bhavna Gupta*

DOI : 10.32474/GJAPM.2019.01.000107

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Physics is an attempt to describe the fundamental laws of world around us. As anesthesiologists we deal with liquids and gases under pressure at varying temperature and volume. These inter relationships are simple, measurable and their understanding ensures a safe outcome for the patient. For the safe and efficient use of anesthesia apparatus, a basic knowledge of fundamental physics is must for a clear concept of their working principle. We have tried to simplify the basic physics related to anesthesia in a simplified way through the review article...... ReadMore

Bhavna Gupta* and Anshul Goyal

DOI : 10.32474/GJAPM.2019.01.000106

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Arnold chiari malformation (ACM) Type II is a developmental abnormality of the brainstem and cerebellar tonsil, medulla and protrusion of 4th ventricle into cervical spinal canal. To best of our knowledge, there is paucity of literature regarding anesthetic management of cases with ACM type II. The anesthetic concerns with general anesthesia are related to the risk of autonomic dysfunction, difficult airway management, damage to the spinal cord and sensitivity to neuromuscular blocking agents. There is risk of increasing intracranial pressure and brainstem compression or herniation leading to hemodynamic and respiratory compromise, due to presence of meningomyelocoele, syringohydromyelia and tethered spinal cord...... ReadMore

Abhay Singh Bhadauria, Jitendra Agrawal* , Rakhi Mitta and Bhanu Choudhary

DOI : 10.32474/GJAPM.2019.01.000105

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Aim: To assess the effects of pneumoperitoneum on respiratory Mechanics and Hemodynamics in Laparoscopic Cholecystectomy Background: Laparoscopic surgeries have been performed now a day�s very frequently. The pneumoperitoneum created in these laparoscopic procedures produces various effects on haemodynamic and respiratory parameters of the patients.Method: 61 patients of ASA grade I and II undergoing laparoscopic cholecystectomy were registered for this study. After induction of GA these patients were ventilated mechanically with tidal volume of 8ml/ kg and RR of 18/min. Haemodynamic (HR, SBP, DBP and MAP) and respiratory mechanics parameter (Peak inspiratory pressure, peak plateau pressure, et CO2, spO2 and end tidal volume) and arterial blood samples (pH, paCO2 and base deficit/excess) were recorded an..... ReadMore

Junko Nakahira*, Shoko Nakano, Toshiyuki Sawai, Yu Miyazaki, Shunsuke Fujiwara, and Toshiaki Minami

DOI : 10.32474/GJAPM.2019.01.000104

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Background: A novel bladder preservation therapy has been developed for patients with muscle-invasive bladder cancer called the Osaka Medical College (OMC) regimen. This regimen comprises balloon-occluded arterial infusion (BOAI) of an anticancer agent and with or without concurrent hemodialysis. Anticancer agents, such as cisplatin, can cause neurotoxicity, leading to peripheral neuropathy. This study aimed to investigate the occurrence of neuropathy after BOAI followed by a second transurethral resection of a bladder tumor (TURBT). We also aimed to investigate the effects of general and spinal anesthesia on neuropathy..... ReadMore

Jeremy Simon , Jeffrey Gehret, Garett Helber, Christopher Mehallo, Michael Mehnert and Robin Raju*

DOI : 10.32474/GJAPM.2019.01.000103

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Concomitant presentation of neck and shoulder pain is a common clinical scenario which can present a significant diagnostic and therapeutic dilemma. Neck and shoulder pain presentations can be separated into four different categories: Primary neck pathology with referred pain to the shoulder, primary shoulder pathology with referred pain to the neck, primary neck and primary shoulder pathology, and primary neck pathology resulting in secondary shoulder pathology. Primary neck pathology resulting in secondary shoulder pathology is mechanically plausible but not proven. Authors are proposing this scenario to be described as �neck-shoulder syndrome.� For instance, C5 and/or C6 cervical radiculopathy can result in rotator cuff, deltoid, biceps and scapular muscle weakness as these nerve roots innervate t..... ReadMore

Redouane Mecharnia, Salim Al Lahham*, Rehan Zahid, Ruba Sada, Saif Badran, Ahmed Mofeed Mokhalalati, Shyias Mohammedali, Mutaz Abuelgasim and Talal Al Hermi

DOI : 10.32474/GJAPM.2019.01.000102

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Patient with coccydynia are often not easy to manage, the aim of this single case study was to describe the outcome of ganglion impar pulsed radiofrequency (PRF) of patient with intractable coccydynia. A 31 years old presented with severe coccydynia, symptom provocation occurred during long sitting, pain reached high level (NRS: 8/10). MRI showed degenerative changes in the sacrococcygeal junction. A first session of impar ganglion PRF for 8 min was applied and the patient was improved 80% for few months (NRS: 2-3/10), although the results of this case report cannot be generalized, it describes the successful outcome of patient with severe coccydynia..... ReadMore

Andrey Belousov*, Elena Malygon, Vadim Yavorskiy and Ekateryna

DOI : 10.32474/GJAPM.2018.01.000101

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This study was devoted to the learning of the use of nanotechnology to correct the functional activity of red blood cells (RBCs) at the storage stages at a positive temperature. It was established that saline NaCl, which had previously been processed by magnetite nanoparticles (ICNB) had a marked membrane-stabilizing effect, inhibits hemolysis and increasing the sedimentation stability of preserved RBCs. The complex analysis of the obtained data allowed to determine the primary mechanisms effect of the saline NaCl, which had previously been processed by ICNB on the preserved RBCs. The proposed method of additive modernization of preserved RBCs was adapted to the production process. The optimisation results were obtained in creating a simple and practical method of additive modernization of preservation solutions that does not violate the ..... ReadMore