Inadvertent Insertion of Hemodialysis Catheter into Brachiocephalic Trunk During Cannulation of Internal Jugular Vein: Management Strategies

Central venous catheter insertion is a commonly performed procedure in the operating room and intensive care unit. It is associated with many complications, some of which may be life-threatening. We report here an accidental insertion of a hemodialysis catheter into the brachiocephalic trunk, which was successfully removed by an endovascular technique.

Myasthenia Gravis and Thymectomy

Myasthenia gravis (MG) is a rare autoimmune neuromuscular disorder. Though MG was diagnosed four centuries ago, its rational management started in 1930s. In the present era, MG is managed by multimodality care including pharmacological agents, plasmapheresis, intravenous immunoglobulins, and surgical thymectomy. Thymectomy has evolved from open trans-sternal to video-assisted thoracoscopic and robotic thymectomy. In this article, the concise history of MG, its clinical features, diagnosis, and management are described.

Mucormycosis: An Uncommon Cutaneous Infection at Permanent Pacemaker-Implanted Site in a Very Low-Birthweight Baby

Permanent pacemaker implantation in low birthweight (LBW) babies with congenital complete heart block is extremely challenging due to a paucity of appropriate pulse generator placement pocket sites. The development of infection following an implantation procedure can pose a life-threatening risk to the patients. With more patients in the younger group receiving these devices than ever before and the rate of infection increasing rapidly, a closer look at the burden of infection and its impact on outcome of these patients is warranted. We report mucormycosis infection at the abdominal pacemaker pocket site of an infant requiring pacemaker explantation and re-insertion into the intrapleural space.

Large Right Atrial Myxoma Masquerading as Malignancy

A 57-year-old female presented to emergency with features of right heart failure. On evaluation, she was found to have a large mass occupying right atrium (RA) completely and protruding into right ventricle through tricuspid valve. Intraoperatively, mass was seen arising from RA free wall with stony hard consistency. Histopathology revealed it to be myxoma. We present this case for the rare presentation of myxoma masquerading as malignancy.

“CON: TIVA versus Inhalational Agents for Pediatric Cardiac Intensive Care”.

The field of pediatric intensive care has come a long way, especially with the recognition that adequate sedation and analgesia form an imperative cornerstone of patient management. With various drugs available for the same, the debate continues as to which is the better: total intravenous anesthesia (TIVA) or inhalational agents. While each have their own advantages and disadvantages, in the present era of balance toward the IV agents, we should not forget the edge our volatile agents (VAs) might have in special scenarios. And ultimately as anesthesiologists, let us not forget that be it knob and dial, or syringe and plunger, our aim is to put pain to sleep and awaken a new faith to breathe.

Immature Platelet Fraction and COVID-19: Maturing prognostic links!

Prompted by the combination of an ever-evolving comprehension of the platelet activation as a pivotal perpetuator of an ongoing systemic inflammatory process and an encouraging literature on the prognostic role of immature platelet fraction (IPF) in septic and prothrombotic settings, we present an elaborated account of the possible prognostic links between IPF and Coronavirus disease 2019 (COVID-19).

Dual Drainage of TAPVR—An Exquisite Connection

Dual drainage or double-connection total anomalous pulmonary venous return (TAPVR) is a rare variant in which all four pulmonary veins enter a common venous chamber that then drains into the systemic veins via two or more channels at the supracardiac, cardiac, or infra-cardiac levels. The traditional classification of total anomalous pulmonary venous connection (TAPVC) does not categorize dual drainage separately.We present a case of TAPVR with dual drainage in a 6-year-old child with a rare variety of connection.