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   2012| January-February  | Volume 56 | Issue 1  
    Online since February 29, 2012

 
 
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SPECIAL ARTICLES
Simulation and anaesthesia
Milind Bhagwat
January-February 2012, 56(1):14-20
DOI:10.4103/0019-5049.93338  PMID:22529414
Training in anaesthesia relies on the duration and quality of clinical experience. It involves exposure to a range of interventions. This works well in routine cases, but when an uncommon and life-threatening event occurs, the anaesthetist needs to carry out multiple tasks simultaneously. Aviation has remarkable similarities with the practice of anaesthesia. Over the years, the aviation industry has used simulation to train and assess individuals very effectively. Anaesthetists face rapidly evolving clinical situations. This needs appropriate decision-making and communication with others in the theatre team. Simulation, using current technology, offers innovative and reproducible training experience. It enables standardised scenario building and reflective learning. Various non-technical aspects of an anaesthetist's day-to-day work could also be addressed to during such training. The technology could be used very effectively for the assessment of competence too. Simulation has been used for technology development and appraisal over the years.
  10,886 4,353 1
Psychiatric patient and anaesthesia
Joginder Pal Attri, Neeru Bala, Veena Chatrath
January-February 2012, 56(1):8-13
DOI:10.4103/0019-5049.93337  PMID:22529413
Many patients with psychiatric illnesses are prescribed long-term drug treatment, and the anaesthesiologist must be aware of potential interactions with anaesthetic agents. Psychotropic drugs often given in combination with each other or with other non-psychiatric drugs generally exert profound effects on the central and peripheral neurotransmitter and ionic mechanisms. Hence, prior intake of these drugs is an important consideration in the management of the patient about to undergo anaesthesia and surgery. This article highlights the effects of anaesthetics on patients taking antipsychotics, tricyclic antidepressants, monoamine oxidase inhibitors and lithium carbonate. The risk that should be considered in the perioperative period are the extent of surgery, the patient's physical state, anaesthesia, the direct and indirect effects of psychotropics, risk of withdrawal symptoms and risk of psychiatric recurrence and relapse.
  6,269 2,279 9
CLINICAL INVESTIGATIONS
Oral pregabalin premedication for attenuation of haemodynamic pressor response of airway instrumentation during general anaesthesia: A dose response study
Bhawna Rastogi, Kumkum Gupta, Prashant K Gupta, Salony Agarwal, Manish Jain, Himanshu Chauhan
January-February 2012, 56(1):49-54
DOI:10.4103/0019-5049.93344  PMID:22529420
Background: The airway instrumentation of direct laryngoscopy and tracheal intubation are powerful noxious stimuli that should be attenuated by appropriate premedication, smooth induction and rapid intubation. The present study evaluated the safe and clinically effective dose of oral pregabalin premedication for attenuation of haemodynamic pressor response of airway instrumentation. Methods: A total of 90 normotensive adult consented patients aged 24-56 years, ASA grade I and II, of both gender were randomized into three treatment groups of 30 patients each. Group I received oral placebo, Group II oral pregabalin 75 mg and Group III oral pregabalin 150 mg 1 h prior to induction. Anaesthetic technique was standardized and all groups were assessed for pre-operative sedation, haemodynamic changes after the premedication, before and after induction, after laryngoscopy and intubation, along with intraoperative haemodynamic stability and post-operative side-effects. Results: Pre-operative sedation levels were higher with pregabalin premedication. Significant increase in heart rate and mean arterial pressure was observed in Groups I and II after airway instrumentation, while statistically significant attenuation of mean arterial pressure was seen in Group III. No significant decrease in heart rate was observed in any group. None of the patient has suffered from any post-operative side-effects, and no significant differences in the parameters of recovery and awakening time were observed. Conclusion: Oral pregabalin premedication has adequately sedated the patients. The haemodynamic pressor response of airway instrumentation was attenuated in a dose-related fashion. The premedicated patients were haemodynamically stable perioperatively without prolongation of recovery time and side-effects.
  4,366 1,103 5
Multiple-injection thoracic paravertebral block as an alternative to general anaesthesia for elective breast surgeries: A randomised controlled trial
Sabyasachi Das, Pradipta Bhattacharya, Mohan Chandra Mandal, Soma Mukhopadhyay, Sekhar Ranjan Basu, Bikas Kusum Mandol
January-February 2012, 56(1):27-33
DOI:10.4103/0019-5049.93340  PMID:22529416
Background: General anaesthesia is currently the conventional technique used for surgical treatment of breast lump. Paravertebral block (PVB) has been used for unilateral procedures such as thoracotomy, breast surgery, chest wall trauma, hernia repair or renal surgery. Methods: We compared unilateral thoracic PVB with general anaesthesia (GA) in 60 consenting ASA physical status I and II female patients of 18-65 years age, scheduled for unilateral breast surgery. Patients were randomly assigned into two groups, P (n=30) or G (n=30), to receive either PVB or GA, respectively. Results: The average time to first post-operative analgesic requirement at visual analogue scale score≥4 (primary endpoint) was significantly longer in group P (303.97±76.08 min) than in group G (131.33±21.36 min), P<0.001. Total rescue analgesic (Inj. Tramadol) requirements in the first 24 h were 105.17±20.46 mg in group P as compared with 176.67±52.08 mg in group G (P<0.001). Significant post-operative nausea and vomiting requiring treatment occurred in three (10.34%) patients of the PVB group and eight (26.67%) patients in the GA group. Conclusion: The present study concludes that unilateral PVB is more efficacious in terms of prolonging post-operative analgesia and reducing morbidities in patients undergoing elective unilateral breast surgery.
  4,245 1,042 10
Post-operative pain and analgesic requirements after paravertebral block for mastectomy: A randomized controlled trial of different concentrations of bupivacaine and fentanyl
V Bhuvaneswari, Jyotsna Wig, Preethy J Mathew, Gurpreet Singh
January-February 2012, 56(1):34-39
DOI:10.4103/0019-5049.93341  PMID:22529417
Background: Paravertebral block (PVB) is useful for post-operative analgesia after breast surgery. Bupivacaine is used for PVB at higher concentrations (0.5%), which may lead to systemic toxicity after absorption. Therefore, we proposed to evaluate the efficacy of lower concentrations of bupivacaine with and without fentanyl for thoracic PVB in patients undergoing surgery for carcinoma breast. Methods: Forty-eight patients scheduled for surgery for breast cancer were enrolled in this prospective, randomized, double-blinded, placebo-controlled trial and were allocated to one of four groups: 0.25% bupivacaine with epinephrine 5 mcg/ ml, 0.25% bupivacaine + epinephrine 5 mcg/ ml with 2 mcg/ml fentanyl, 0.5% bupivacaine + epinephrine 5 mcg/ml or isotonic saline. PVB was performed and 0.3 ml/kg of the test drug was administered before induction of general anaesthesia. The primary outcome assessed was post-operative analgesic requirement for a period of 24 h. Secondary outcome measures were post-operative pain scores at rest and on movement of the arm, latency to first opioid, post-operative nausea and vomiting, quality of sleep, ability to move arm and patient satisfaction. Results: The patient characteristics and anaesthetic technique were comparable among the groups. The rescue analgesic consumption as well as cumulative pain scores at rest and on movement were significantly less in 0.25% bupivacaine+epinephrine with fentanyl and 0.5% bupivacaine+epinephrine groups (P<0.05). The average duration of analgesia was found to be 18 h after either 0.25% bupivacaine with epinephrine+fentanyl or 0.5% bupivacaine with epinephrine. Conclusions: Lower concentrations of bupivacaine can be combined with fentanyl to achieve analgesic efficacy similar to bupivacaine at higher concentrations, decreasing the risk of toxicity in PVB.
  3,803 997 12
EDITORIAL
Fraud in anaesthetic research and publication
SS Harsoor, SB Gangadhar
January-February 2012, 56(1):1-3
DOI:10.4103/0019-5049.93334  PMID:22529412
  3,113 784 7
CASE REPORTS
Seizures after intravenous tramadol given as premedication
Lalit Kumar Raiger, Udita Naithani, Sonali Bhatia, Sandeep Singh Chauhan
January-February 2012, 56(1):55-57
DOI:10.4103/0019-5049.93345  PMID:22529421
A 35-year-old, 50-kg female with a history of epilepsy was scheduled for elective breast surgery (fibroadenoma) under general anaesthesia. She was given glycopyrrolate 0.2 mg, ondansetron 4 mg and tramadol 100 mg i.v. as premedication. Within 5 min, she had an acute episode of generalised tonic-clonic seizure that was successfully treated with 75 mg thiopentone i.v. and after 30 min, she was given general anaesthesia with endotracheal intubation. Surgery, intra-operative period, extubation and post-operative period were uneventful. We conclude that tramadol may provoke seizures in patients with epilepsy even within the recommended dose range.
  2,971 680 3
Congenital complete heart block and spinal anaesthesia for caesarean section
A Umesh Kumar, R Sripriya, S Parthasarathy, B Amirtha Ganesh, M Ravishankar
January-February 2012, 56(1):72-74
DOI:10.4103/0019-5049.93350  PMID:22529426
Congenital complete heart block could be absolutely asymptomatic. Increased awareness of suspecting an atrioventricular heart block in patients with slow heart rate and electrocardiograph examination will ensure recognition of this problem. The possibility of sudden cardiac death in these patients should not be forgotten. The goal in the peri-operative anaesthetic management is to preserve the heart rate and maintain haemodynamic stability. Herein, we present a case of congenital complete heart block posted for elective caesarean section for an obstetric indication. We would like to highlight the advantage of bupivacaine-fentanyl combination in maintaining haemodynamic stability and peri-operative heart rate control with temporary pacemaker.
  2,711 656 -
CLINICAL INVESTIGATIONS
Comparative evaluation of ropivacaine and lignocaine with ropivacaine, lignocaine and clonidine combination during peribulbar anaesthesia for phacoemulsification cataract surgery
Balbir Khan, Sukhminder Jit Singh Bajwa, Ravi Vohra, Sukhwinder Singh, Rajwinder Kaur, Vartika , Asha
January-February 2012, 56(1):21-26
DOI:10.4103/0019-5049.93339  PMID:22529415
Background: Peribulbar block is the most common type of local anaesthesia administered for cataract surgery, and continuous efforts are on to find a long-acting local anaesthetic (LA) drug with the safest pharmacological profile. Objectives: A double-blind, prospective and randomized study was carried out in our institute to compare the anaesthetic effects of ropivacaine with the combination of ropivacaine and clonidine in administration of peribulbar block for phacoemulsification cataract surgery. Methods: A total of 200 patients of both sexes aged 50-80 years of American Society of Anaesthesiologists grade I and II, scheduled for phacoemulsification cataract surgery under monitored anaesthesia care, were enrolled for the study. Patients were assigned into two groups of 100 each; ropivacaine group (R) and ropivacaine clonidine group (RC). Group R received 10 mL of LA solution containing 5 mL of 2% lignocaine, 5 mL of 0.75% ropivacaine and 100 units of hyaluronidase while group RC received 8 mL of a similar mixture with the addition of clonidine 1 μg/kg and saline to make a total volume of 10 mL. Heart rate (HR), mean arterial pressure (MAP), pulse oximetry (SpO 2 ), respiratory rate (RR), intraocular pressure (IOP), eye muscle movement scores and quality of peribulbar block were observed and recorded throughout the study period at regular intervals. At the end of the research project, the data was compiled systematically and was subjected to statistical analysis using the ANOVA test with post hoc significance for continuous variables and Chi-square test for qualitative data. Value of P<0.05 was considered significant and P<0.0001 as highly significant. Results: Demographic characteristics, SpO 2 and RR were comparable in both the groups. Mean HR and MAP were also comparable after a significant variation in the first 2-3 min (P<0.05). Onset and establishment of sensory and motor blocks were significantly earlier in the RC group (P<0.05). IOP decreased significantly during the first 6-7 min in the RC group after the administration of the peribulbar block. Duration of analgesia was prolonged in the RC group (6.5±2.1 h) as compared with the R group (4.2±1.8 h). The side-effect profile revealed a higher incidence of nausea, vomiting, headache and dizziness in Group R, while a considerably higher incidence of dry mouth was observed in Group RC. Conclusions: Addition of clonidine to ropivacaine not only decreases the total volume of LA to be used but also augments early onset and prolonged offset of sensory analgesia as well as provides smooth operating conditions with a good sedation level as well by providing a wider safety margin of LA.
  2,431 702 5
CASE REPORTS
Unilateral neurogenic pulmonary oedema: An unusual cause for post-operative respiratory dysfunction following clipping of ruptured intracranial aneurysm
Padmaja Durga, Nirmala Jonnavithula, Manas Kumar Panigrahi, Srinivas Mantha
January-February 2012, 56(1):58-61
DOI:10.4103/0019-5049.93346  PMID:22529422
A variety of central nervous system lesions like stroke, subarachnoid haemorrhage, trauma and seizure activity can result in neurogenic pulmonary oedema (NPE). Unilateral neurogenic pulmonary oedema is very rare. There are no reports of unilateral NPE with aneurysmal vasospasm. We present the case of a 55-year-old female who developed respiratory distress with unilateral pulmonary oedema and mild left ventricular dysfunction in the context of postoperative cerebral vasospasm following clipping of ruptured intracranial aneurysm. Neurogenic pulmonary oedema should always be in the differential diagnosis when patients with presumed neurogenic pathology develop respiratory compromise. The diagnosis of unilateral neurogenic pulmonary oedema requires a high index of suspicion. Early initiation of supportive treatment results in good outcome.
  2,608 461 -
PAST PRESIDENT’S MESSAGE
The President's Inaugural Address during ISACON 2011, on 28 th December 2011 at Mumbai
Deepak Malviya
January-February 2012, 56(1):6-7
DOI:10.4103/0019-5049.93336  
  2,678 367 -
CASE REPORTS
Negative-pressure pulmonary oedema in a patient undergoing shoulder arthroscopy
Anoop Raj Gogia, Jeetendra Bajaj, Ameeta Sahni, Deepti Saigal
January-February 2012, 56(1):62-65
DOI:10.4103/0019-5049.93347  PMID:22529423
An 18-year-old ASA-I patient who underwent elective left shoulder arthroscopy developed severe airway obstruction post-extubation due to fluid extravasation from the shoulder joint into the neck and airway tissue. Re-intubation for relief of obstruction resulted in negative-pressure pulmonary oedema. The patient was electively ventilated in the intensive care unit and recovered uneventfully. A high index of suspicion along with monitoring of neck circumference can prevent this kind of complication.
  2,413 572 4
LETTERS TO EDITOR
Ultrasound-guided transversus abdominis plane block in obese patients
Gokul Toshniwal, Vitaly Soskin
January-February 2012, 56(1):104-105
DOI:10.4103/0019-5049.93368  PMID:22529445
  2,528 434 4
BRIEF COMMUNICATIONS
Comparison of arm and calf blood pressure
Parul Sareen, Kirti Saxena, Bhuwan Sareen, Bharti Taneja
January-February 2012, 56(1):83-85
DOI:10.4103/0019-5049.93354  PMID:22529430
  2,397 536 10
CASE REPORTS
Timely 'off-label' use of recombinant activated factor VII (NovoSeven® ) can help in avoiding hysterectomy in intractable obstetric bleeding complicated with disseminated intravascular coagulation: A case report and review of the literature
Jyoti Burad, Pradipta Bhakta, Jasvinder Sharma
January-February 2012, 56(1):69-71
DOI:10.4103/0019-5049.93349  PMID:22529425
Massive intra-operative bleeding is not an infrequent occurrence in obstetrics. Worldwide obstetric bleeding remains a major cause of morbidity and mortality. Conventional management of this bleeding consists of resuscitation with fluids, blood, surgical maneuvers, and embolisation of feeding blood vessels. But in most of cases, these measures appear to be ineffective in controlling bleeding. Recently, the 'off-label' use of the recombinant activated factor VII (rFVIIa) concentrate has emerged as promising treatment for such bleeding when conventional measures fail. We came across a similar scenario in which a young lady was admitted with per-vaginal bleeding due to abruptio placentae. In spite of usual surgical and medical interventions, she continued to bleed. rFVIIa was administered as a desperate measure to avoid hysterectomy and the bleeding could be stopped. She recovered successfully without any complication. Thus, the timely use of rFVIIa, hence, can be used to save life and fertility in cases of intractable obstetric bleeding.
  2,342 566 -
Anaesthetic management of a patient with isolated pulmonary stenosis posted for caesarean section
Channabasavaraj S Sanikop, Vijay S Umarani, GS Ashwini
January-February 2012, 56(1):66-68
DOI:10.4103/0019-5049.93348  PMID:22529424
Cardio circulatory changes associated with pregnancy result in a significant haemodynamic burden and lead to morbidity and even mortality in women with cardiac disease. We report a rare case of severe pulmonary stenosis who underwent elective caesarean section under general anaesthesia with satisfactory maternal and neonatal outcome.
  2,141 543 1
BRIEF COMMUNICATIONS
Successful conservative management in post-intubation tracheal rupture
Ashish Bangaari, Balaji Prabaharan, Trevor Nair
January-February 2012, 56(1):85-87
DOI:10.4103/0019-5049.93355  PMID:22529431
  2,255 398 -
LETTERS TO EDITOR
Weaning from prolonged mechanical ventilation: The complete picture
Ashish K Khanna
January-February 2012, 56(1):102-103
PMID:22529443
  1,902 670 -
Can we use Tramadol as an anti-shivering agent?
Chhaya Joshi, Uday Ambi, Pramod Mirji
January-February 2012, 56(1):91-92
DOI:10.4103/0019-5049.93359  PMID:22529435
  1,879 499 1
CLINICAL INVESTIGATIONS
Size 2.5 ProSealTM LMA: Is it associated with increased attempts at insertion?
Aparna Sinha, Bimla Sharma, Jayashree Sood
January-February 2012, 56(1):44-48
DOI:10.4103/0019-5049.93343  PMID:22529419
Background: This randomized controlled study evaluated the success rate of insertion and the associated oropharyngeal morbidity for sizes 1.5,2 and 2.5 of ProSeal TM laryngeal mask airway (PLMA) using an alternative digital technique (D) with conventional technique using the introducer tool (IT) technique. Methods: After approval from the hospital ethics committee, 250 healthy children, 6-months to 10 years of age, undergoing elective sub-umbilical surgeries, were included and randomly allocated to D and IT groups for PLMA insertion. The standard anaesthesia protocol was followed. The primary outcomes were success rate of insertion at first attempt and blood on device on removal and the secondary outcomes were oropharyngeal leak pressure and gastric tube placement. Results: The success rate of PLMA insertion at first attempt for sizes 1.5 and 2 did not differ between the two groups. However, for size 2.5, it was significantly lower than that for the other two sizes in both groups. The incidence of blood on device was higher with the 2.5 airway in both groups, reaching statistical significance only in group D. Other parameters did not differ between the two groups. Conclusion: We conclude that size 2.5 PLMA is associated with a lower success rate of insertion and a higher incidence of blood on device using both techniques. Insertion of PLMA sizes 1.5 and 2 by an alternative digital technique is comparable to the IT technique.
  1,900 413 -
BRIEF COMMUNICATIONS
Transdermal nitroglycerine enhances the post-operative analgesic effect of intrathecal clonidine in abdominal hysterectomies
Mamta Khandelwal, Fareed Ahmed, Ashish Garg, AP Verma, Aquil , CS Chatterjee
January-February 2012, 56(1):79-81
DOI:10.4103/0019-5049.93352  PMID:22529428
  1,922 371 -
CASE REPORTS
Novel anaesthetic approach for surgical access and haemodynamic management during off-pump coronary artery bypass through a left thoracotomy
Madan Mohan Maddali, Abdullah M Al-Jadidi, Sunny Zacharias
January-February 2012, 56(1):75-78
DOI:10.4103/0019-5049.93351  PMID:22529427
For myocardial revascularization on a beating heart through a thoracotomy, a properly deployed endobronchial blocker (EBB) provides ideal conditions for surgical access. In addition, adequate volume replacement to achieve optimal cardiac performance is a primary goal of haemodynamic management in patients undergoing off-pump coronary artery bypass grafting. To achieve both these ends, this case report describes the combined use of a left-sided EBB along with a volumetric pulmonary artery catheter in a patient who underwent a successful off-pump coronary artery bypass surgery through an anterolateral thoracotomy.
  1,886 387 1
BRIEF COMMUNICATIONS
A rare, potentially hazardous, malposition of the nasotracheal tube
Murali Chakravarthy, Srinivasa Holla, Naveen Gowda, Ashok Anand, Kumaraswamy Mattur, Keshava Reddy, Sudheer Kumar, Rajathadri Simha
January-February 2012, 56(1):81-83
DOI:10.4103/0019-5049.93353  PMID:22529429
  1,903 364 2
CLINICAL INVESTIGATIONS
Intra-operative change of gastric pH during laparotomic cholecystectomy under general anaesthesia: A prospective case-control study
Binay Kumar Biswas, Balakrishna Bhattarai, Pradipta Bhakta, Samarjit Dey, Prithwish Bhattacharyya
January-February 2012, 56(1):40-43
DOI:10.4103/0019-5049.93342  PMID:22529418
Background: Gastric decompression by suctioning often shows greenish/greenish-yellow-coloured gastric aspirates following cholecystectomy under general anaesthesia (GA). Possible intraoperative regurgitation of duodenal contents into stomach because of surgical manipulation may be the reason for such alteration in colour of the gastric secretions. Aim: We conducted this study to determine whether there were any pH changes of gastric secretions during laparotomic cholecystectomy operation to confirm our hypothesis of regurgitation of duodenal contents into the stomach. Settings and Designs: Prospective observational controlled study in the Department of Anaesthesiology and Critical Care in a tertiary care university teaching hospital. Methods: Fifty adult ASA I and II patients scheduled for open cholecystectomy operation under GA were included in the study group and another 50 non-abdominal surgical patients without any gall bladder disease were taken as controls. Three to five milliliters of gastric secretions were aspirated just after intubation and also before reversal of residual neuromuscular blockade for analysis of pH. Statistical Analysis: Analysis of variance test and Chi-square test with Fisher's exact correction were used for statistical analysis. Differences were significant when the P value was <0.05. Results: Post-operative values of pH in the study group were significantly higher than their pre-operative values (2.40±1.10 vs. 4.04±1.6, P≤0.001). Forty-nine patients (98%) in the study group had altered coloured post-operative gastric aspirations, while no patient in the control group had such changes (P<0.001). Conclusions: A significant change in gastric pH takes place during laparotomic cholecystectomy due to reflux of duodenal content into the stomach.
  1,757 455 -
LETTERS TO EDITOR
Ayurvedic medicine and anaesthesia
Asmita P Karnalkar, Philip Mathew, AV Nadkarni, VK Dhulkhed, SS Belapure
January-February 2012, 56(1):96-97
DOI:10.4103/0019-5049.93363  PMID:22529439
  1,734 431 1
Potassium chloride: A high risk drug for medication error
Dilip Kothari, Saroj Kothari, Jitendra Agrawal
January-February 2012, 56(1):90-91
DOI:10.4103/0019-5049.93357  PMID:22529434
  1,513 496 1
Removal of sewing needle in upper oesophagus: An innovative role of Magill forceps
Santosh Kumar Sharma, Shahbaz Ahmad, Deepak Malviya, SA Nadeem, KC Raghu
January-February 2012, 56(1):92-94
DOI:10.4103/0019-5049.93360  PMID:22529436
  1,687 299 -
PRESIDENTS MESSAGE
From the desk of the New President
Anjan Datta
January-February 2012, 56(1):4-5
DOI:10.4103/0019-5049.93335  
  1,541 372 -
LETTERS TO EDITOR
Fentanyl, rather than Tramadol: A cause of respiratory depression
Ghansham Biyani, Sadik Mohammed, Pradeep Bhatia
January-February 2012, 56(1):89-90
DOI:10.4103/0019-5049.93358  PMID:22529433
  1,496 375 -
A new flexible laryngeal mask airway introducer
Anand Hanumantrao Kulkarni, Binu Puthur Simon, Joju Kalan Jose
January-February 2012, 56(1):94-95
DOI:10.4103/0019-5049.93361  PMID:22529437
  1,473 334 -
Pneumothorax and surgical emphysema during therapeutic endobronchial suctioning
Vasudeo U Utpat, A Rangnathan, Shankar V Kadam
January-February 2012, 56(1):100-102
DOI:10.4103/0019-5049.93366  PMID:22529442
  1,463 275 -
Pre-emptive use of bivalirudin for emergent off-pump coronary artery bypass surgery in a suspected case of heparin-induced thrombocytopenia
Dharmesh R Agrawal, Mohammed Rehan Sayeed, Indira Rajani S Roy, K Somaraja
January-February 2012, 56(1):98-99
DOI:10.4103/0019-5049.93364  PMID:22529440
  1,338 381 -
Anaesthesia for non-cardiac surgery in a cardiac transplant recipient
Manuel Á Gómez-Ríos
January-February 2012, 56(1):88-89
DOI:10.4103/0019-5049.93356  PMID:22529432
  1,283 332 2
OBITUARIES
Dr. Yatendra Chandra Rai Vora
Sunanda Gupta
January-February 2012, 56(1):107-107
  1,236 217 -
LETTERS TO EDITOR
An unusual site of an occult air leak in an armoured endotracheal tube in the midst of surgery
Dheeraj Kapoor, Amandeep Singh
January-February 2012, 56(1):99-100
DOI:10.4103/0019-5049.93365  PMID:22529441
  1,144 275 -
OBITUARIES
Dr. (Mrs.) Sethulakshmi
Anjan Datta
January-February 2012, 56(1):106-106
  1,118 237 -
LETTERS TO EDITOR
Authors' reply
Deepak Thapa, Vanita Ahuja, Purva Khandelwal
January-February 2012, 56(1):103-104
DOI:10.4103/0019-5049.93367  PMID:22529444
  1,109 216 -
Lidocaine not so innocent: Cardiotoxicity after topical anaesthesia for bronchoscopy
Michal Horácek, Tomáš Vymazal
January-February 2012, 56(1):95-96
DOI:10.4103/0019-5049.93362  PMID:22529438
  1,036 239 -
OBITUARIES
Dr. Anant Madhav Deshpande
Shakil Momin
January-February 2012, 56(1):109-109
  1,025 225 -
Dr. Amalendu Ghosh
Anjan Datta
January-February 2012, 56(1):108-108
  904 199 -
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