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  Citation statistics : Table of Contents
   2020| August  | Volume 36 | Issue 5  
    Online since August 17, 2020

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Safety tent for enhanced personal protection from aerosol-generating procedures while handling the COVID-19 patient airway
Prasanna Bidkar, Umesh Goneppanavar, Jasvinder Kaur, Srivats Valliyur Ramamoorthy
August 2020, 36(5):157-160
The world is going through the COVID-19 pandemic, which has high virulence and transmission rate. More significant the viral load during exposure, the greater is the likelihood of contracting a severe disease. Healthcare workers (HCWs) involved in airway care of COVID-19 patients are at high risk of getting exposed to large viral loads during aerosol-generating actions such as coughing or sneezing by the patient or during procedures such as bag-mask ventilation, intubation, extubation, and nebulization. This viral load exposure to airway caregivers decreases considerably with the use of an aerosol box during intubation. The safety tent proposed in this article is useful in limiting the viral load that HCWs are exposed to during airway procedures. Its role can be expanded beyond just intubation to protect against all aerosol-generating actions and procedures involving the patient's airway.
  3 1,157 155
Anesthesiologist and COVID-19—current perspective
Subodh Kumar, Sanjeev Palta, Richa Saroa, Sukanya Mitra
August 2020, 36(5):50-57
In the current situation when the world is grappling with COVID-19 that has taken a toll on humanity and is continuing to affect multiples of health-care workers all over the world in vast numbers, the pandemonium (mayhem) has led to grim concerns. We have made an effort to compile and present a review that provides an insight into the management of patients for the front-line anesthesiologists of the medical war, which is being fought to curb and contain this COVID-19 pandemic. We have tried to incorporate the operating room locations, as well as the remote locations where anesthesiologist may be called upon for providing their services. Needless to say, it is of utmost importance to ensure the safety of the patient, as well as of the anesthesiologist who are involved in the patient care at this crucial juncture. The present article provides valuable information to anesthesiologists regarding handling the current pandemic in a protocolized and evidence-based manner.
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Anesthesia practice in Covid-19 era: Unprecedented problems call for extraordinary solutions
Anju Gupta, Sayan Nath, Anjan Trikha
August 2020, 36(5):75-77
  2 1,053 152
Exploring the unknown territories in the new normal world of COVID
Sukhminder Jit Singh Bajwa, Ritu Gupta, Ajay Wahi, S. P. S. Goraya
August 2020, 36(5):77-80
It is now well known that the severe acute respiratory syndrome (SARS-CoV-2) originated in the Wuhan province of Hubei, China in 2019. Having spread across different countries of the world, this highly contagious disease has posed many challenges for the healthcare workers to work without endangering themselves and their patients' wellbeing. Several things are yet not clear about the virus and the presence or absence of the virus in the cerebrospinal fluid (CSF) is currently a debated topic. This article reports the perioperative management of two coronavirus disease-19 positive cases, one of whom was a pregnant patient. Their CSF samples, which were collected during the administration of spinal anesthesia, tested to be negative for viral reverse transcription polymerase chain reaction (RT-PCR) test. We wish to highlight from these cases, that during spinal anesthesia, CSF in mildly symptomatic COVID-19 cases probably does not pose a risk of transmission to the anesthesiologist. However, we suggest that due to the varied presentations of the virus, health care personnel, especially anesthesiologists have to be careful during the perioperative management of such cases.
  2 936 144
Therapeutic status of hydroxychloroquine in COVID-19: A review
Kirandeep Kaur, Sandeep Kaushal, Ishita Gupta Kaushal
August 2020, 36(5):160-165
Hydroxychloroquine (HCQ), a 4-aminoquinoline, is used worldwide mainly for its role in management of malaria and rheumatoid arthritis. In the present pandemic of coronavirus disease (COVID)-2019, the drug is being repurposed, based on its in vitro evidence of efficacy against coronavirus. There has been a lot of information, for and against the drug, and this review is an effort to bring forth the evidence and current understanding regarding role of HCQ in COVID-19. Clinical studies, case reports, and in vitro studies have generated conflicting results. There are concerns for use of HCQ because of the variable results and the known adverse effects like QT prolongation and hypoglycemia. In the current scenario, recommendations from Indian Council of Medical Research for use of HCQ in the prophylaxis of COVID-19 are being followed.
  2 2,175 235
Management of pregnant laboring women during COVID-19 pandemic
Kajal Jain, Nidhi Bhatia, Anju Grewal, Sunil T Pandya, Sunanda Gupta, Rashmi Bagga, Anjan Trikha
August 2020, 36(5):91-96
Since its first outbreak in December 2019 in Wuhan, China, coronavirus disease 2019 (COVID-19) has become a global public health threat. In the midst of this rapidly evolving pandemic condition, the unique needs of pregnant women should be kept in mind while making treatment policies and preparing response plans. Management of COVID-19 parturients requires a multidisciplinary approach consisting of a team of anesthesiologists, obstetricians, neonatologists, nursing staff, critical care experts, infectious disease, and infection control experts. Labor rooms as well as operating rooms should be in a separate wing isolated from the main wing of the hospital. In the operating room, dedicated equipment and drugs for both neuraxial labor analgesia and cesarean delivery, as well as personal protective equipment, should be readily available. The entire staff must be specifically trained in the procedures of donning, doffing, and in the standard latest guidelines for disposal of biomedical waste of such areas. All protocols for the management of both COVID-19 suspects as well as confirmed patients should be in place. Further, simulation-based rehearsal of the procedures commonly carried out in the labor room and the operation theaters should be ensured.
  2 1,298 237
Preventing exposure to COVID-19 in the operation theatre and intensive care unit
Rangraj Setlur, Alok Jaiswal, Nikahat Jahan
August 2020, 36(5):127-133
The COVID-19 pandemic has gripped the world since January 2020 and has changed our lives in unprecedented ways. It has changed the way we work in the Operation Theatres and Intensive Care Units mainly because of the high risk of disease transmission to the healthcare workers. In order to reduce the risk of disease transmission, an understanding of the means of transmission of the virus is essential to develop a rational strategy that allows patients to receive treatment without placing either the patient or healthcare workers at risk. It should be cautioned that this is a rapidly changing field and there is a paucity of randomised controlled trials related to various aspects of the disease. It is therefore advisable to revise any recommendations in this article, as and when new evidence emerges.
  2 1,481 180
The aerosol box
Amjad Maniar, Balavenkatasubramanian Jagannathan
August 2020, 36(5):141-143
Despite being scientifically unproven, aerosol boxes have quickly risen in popularity during the COVID-19 pandemic. They have been created in various shapes and sizes, as well as materials across the world. Aerosol boxes offer a transparent barrier between the patient and the healthcare personnel, during intubation and may prove to be useful when prescribed protection equipment such as masks and eyewear are unavailable. In this article, we undertake a brief overview of aerosol boxes in current practice.
  2 1,021 135
Negative pressure aerosol containment box: An innovation to reduce COVID-19 infection risk in healthcare workers
Vivek Gupta, Ashish Sahani, Bishav Mohan, GS Wander
August 2020, 36(5):144-147
Healthcare workers (HCW's) are at increased risk of corona virus disease (COVID-19) infection during aerosol generating activities. The aerosol box has been used during intubation and extubation to prevent transmission of infection to HCWs. Isolation room with negative pressure has been advocated for COVID-19 patients. The described containment box has been designed to be useful in COVID intensive care unit (ICU) as a multipurpose box which is a cost effective and readily available resource. This innovation combines the containment box with negative pressure generation using central vacuum
  2 9,277 162
Regional anesthesia in the coronavirus disease (COVID-19) pandemic: Clinical guidelines by AORA, India
Vrushali Chandrashekhar Ponde, Sandeep Diwan, Thota Venkata Sanjeev Gopal, J Balavenkata Subramanian, Mohammed Azam Danish
August 2020, 36(5):109-115
Anesthesiologists are amongst the front line warriors in this COVID-19 pandemic. We need to change our preferences and practices to reduce the spread to healthcare workers and patients in the hospital. General anesthesia involves aerosol-generating procedures while ventilating and intubating the patients. Regional anesthesia maintains respiratory functions, circumvents airway instrumentation and helps to limit viral transmission. This makes a strong case to patronize regional anaesthesia practises whenever possible. Due to various limitations of diagnostic tests available, all patients can be treated as COVID-19 positive and necessary precautions are suggested to limit the transmission. The importance of a practise advisory is to clear the mist around the dos and don'ts to ensure clarity of thoughts leading to improved safety of both patient and health care professional. We propose clinical guidelines for regional anaesthesia practices in COVID-19 positive patient posted for surgery. Furthermore, current recommendations on confirming the COVID-19 negative status is referred. These features are subject to change further with time.
  1 1,986 239
COVID aerosol barrier intubation box – Boon or bane?
Shibu Sasidharan, Rakhee Goyal, M Babitha, Suneeta Singh, Harpreet Singh Dhillon
August 2020, 36(5):150-152
  1 998 130
Patient isolation pods for the evacuation of COVID-19 infected patients – Is this the answer?
Shibu Sasidharan, Vijay Singh, Harpreet S Dhillon, M Babitha
August 2020, 36(5):152-155
  1 1,110 125
Respiratory and cardiovascular effects of COVID-19 infection and their management
Mukul Chandra Kapoor
August 2020, 36(5):21-28
The COVID-19 epidemic has put an enormous burden on the health-care system and the economy. The virus has very high infectivity and is crippling in patients developing severe disease. The disease caused by this infective agent, a novel RNA coronavirus (SARS-CoV-2), was named by the World Health Organization as COVID-19. SARS-CoV-2 usually enters the human body from the respiratory tract and gradually causes systemic disease. The disease is mild in 81% and severe in the balance. The virus causes multiorgan damage and primarily damages airway epithelium, small intestine epithelium, and vascular endothelium, which are organs with high angiotensin-converting enzyme (angiotensin-converting enzyme-2 [ACE2] expression). The most affected organ is the lungs, and the cardiovascular system follows it closely. Symptomatic hypoxic patients are initially treated with oxygen supplementation, but those with severe hypoxia need mechanical ventilation support. Patients with COVID-19 infection present as two phenotypes. The ventilation strategy should be based on the phenotype. The disease causes major hemodynamic disturbances in its invasion of the cardiovascular system. Strict personal protection protocols are needed to ensure the safety of health-care workers and nosocomial spread.
  1 1,937 287
Sign language in anesthesiology in times of novel corona virus pandemic
M Rupinder Singh, Sandeep Kundra, Saru Singh, Anju Grewal, Tanveer Singh
August 2020, 36(5):81-82
  - 615 124
Practical considerations for performing brachial plexus blocks in suspected COVID-19 patients
Sandeep Diwan, Abhijit Nair, Vrushali Ponde
August 2020, 36(5):83-85
  - 604 107
Practical approach for safe anesthesia in a COVID-19 patient scheduled for emergency laparotomy
Umesh Goneppanavar, Sameer Desai, Jasvinder Kaur, Rajesh S Phatake, Roopa Sachidananda, Ravi Bhat
August 2020, 36(5):57-61
COVID-19 patients presenting for emergency laparotomy require evaluation of surgical illness and viral disease. As these patients are likely to have a wide spectrum of deranged physiology and organ dysfunction, optimization should start preoperatively and continue through intraoperative and postoperative recovery periods along with appropriate antimicrobial cover. The goal should be not to delay damage control surgery in favor of evaluation and optimization. When a COVID-19 positive or suspected patient is to be operated for laparotomy, the situation often demands general anesthesia with invasive monitoring and analgesia complemented by regional anesthesia to minimize postoperative opioid requirements to facilitate early recovery. This particular article addresses the issues related to emergency laparotomy management in relation to COVID-19 patient. Healthcare workers should diligently use effective PPE and practice disinfection to prevent spread. Video-communication is an effective means of evaluation. Information expected from investigations should be weighed against risk of exposure to healthcare workers/laypersons. Simulation and memory aids should be used to familiarize team members with roles and techniques of management while in PPE. Step-wise detailed planning for patient transfer, anesthesia induction, maintenance and emergence, aid in enhancing HCW safety without compromising patient care.
  - 1,283 243
Development of a preoperative Early Warning Scoring System to identify highly suspect COVID-19 patients
Zulfiqar Ali, Umesh Goneppanavar, Pradeep A Dongare, Rakesh Garg, Sudheesh Kannan, SS Harsoor, S Bala Bhaskar
August 2020, 36(5):62-74
Background and Aims: The coronavirus disease 2019 (COVID-19) is spreading at an unprecedented speed. Lack of resources to test every patient scheduled for surgery and false negative test results contribute to considerable stress to anesthesiologists, along with health risks to both caregivers and other patients. The study aimed to develop an early warning screening tool to rapidly detect 'highly suspect' among the patients scheduled for surgery. Methods: Review of literature was conducted using terms 'coronavirus' OR 'nCoV 2019' OR 'SARS-CoV-2' OR 'COVID-19' AND 'clinical characteristics' in PUBMED and MedRxiv. Suitable articles were analysed for symptoms and investigations commonly found in COVID-19 patients. Additionally, COVID-19 patient's symptomatology and investigation profiles were obtained through a survey from 20 COVID-19 facilities in India. Based on literature evidence and the survey information, an Early Warning Scoring System was developed. Results: Literature search yielded 3737 publications, of which 195 were considered relevant. Of these 195 studies, those already included in the meta-analyses were not considered for independent assessment. Based on the combined data from meta-analyses and survey, risk factors of COVID-19 disease identified were as follows: history of exposure, fever, cough, myalgias, lymphocytopaenia, elevated C-reactive protein (CRP)/lactate dehydrogenase (LDH) and radiographic infiltrates. Conclusion: Development of this Early Warning Scoring System for preoperative screening of patients may help in identifying 'highly suspect' COVID-19 patients, alerting the physician and other healthcare workers on the need for adequate personal protection and also to implement necessary measures to prevent cross infection and contamination during the perioperative period.
  - 1,592 217
Re-inventing anesthesia in times of Covid-19
Gauri R Gangakhedkar, Indrani H Chincholi
August 2020, 36(5):48-50
  - 1,053 134
Fast tracking intensive care units and operation rooms during the COVID-19 pandemic in resource limited settings
Richa Aggarwal, Ridhima Bhatia, Kapil Dev Soni, Anjan Trikha
August 2020, 36(5):7-14
The ongoing pandemic of COVID-19 has affected more than 43 million people all over the world with about 280000 deaths worldwide at the time of writing this article The outcome of this pandemic is impossible to predict at the present time as the numbers of both, infected patients and those dying of the disease are increasing on a daily basis. China, Italy, France, Spain, Germany, United Kingdom, and USA are the worst affected countries. All these countries have robust health care systems but despite this there has been a huge shortage of health care facilities especially intensive care beds in these countries. A country like India has different challenges as far as medical care during this pandemic is concerned. The need of the hour is to improve the health care system as a whole. In the present pandemic this involves setting up of patients screening facilities for the disease, enhancing the number of hospital beds, setting up of dedicated high dependency units, intensive care units and operation theatres for COVID positive patients. The present article describes in brief the way this can be done in a short time.
  - 1,316 229
Ensuring adequate healthcare in COVID and non-COVID areas: An unprecedented challenge
Sandhya Yaddanapudi
August 2020, 36(5):6-7
  - 909 166
Cohabitation with COVID
Mukul Chandra Kapoor
August 2020, 36(5):4-6
  - 925 175
COVID-2019: Experience of setting up quarantine center
Rashmi Datta
August 2020, 36(5):14-18
Indians stranded in countries reporting widespread transmission of COVID-19 in Jan to Mar 2020 were evacuated at short notice. Unclear and evolving evidence on COVID-19, risk of transmission of the disease from pre-symptomatic, asymptomatic and known cases of COVID-19 has put the spotlight back on the practice of quarantine. The article describes the processes, inter-sectoral coordination and methodology adopted for putting in place all measures for a successful evacuation and subsequent quarantine of the evacuees at the first Quarantine camp set up in India at Manesar, Gurugram near New Delhi by the Armed Forces. No health care worker or support staff contracted any infection with SARS-Cov-2 during the period of care and contact with those quarantined. The archaic practice of quarantine has yet again proven to be a robust and effective Public Health tool with great relevance in the ongoing Pandemic of COVID-19.
  - 1,647 137
Live in fear or make our lives better?
Rakhee Goyal, Anju Grewal
August 2020, 36(5):2-4
  - 840 186
Staying afloat and reaching the shore in COVID sea
Naveen Malhotra
August 2020, 36(5):1-2
  - 888 220
Traditional Indian practices: Time to revisit and re-adopt for a healthier lifestyle
Ruchita Tyagi, Vivek Gupta, Rajiv Kumar, GS Wander
August 2020, 36(5):166-171
The COVID-19 pandemic has affected human life significantly. In spite of significant advancement of medical technology, management is still focused on preventive strategies due to non availability of vaccine or any definitive treatment. The preventive strategies include hand hygiene, social distancing, isolation/quarantine along with the methods for boosting immunity. The ancient literature and several traditional practices of our country guide a hygienic life style and address several preventive aspects of transmission of infection across the society. Furthermore, healthy eating habits and use of various herbs and spices as regular food ingredients has been proven for boosting the immunity. In this review, we have tried to correlate the traditional practices with the available scientific evidences.
  - 1,700 178
What a pediatric anesthesiologist should know about COVID-19
Aditi Jain, Neerja Bhardwaj, Sandhya Yaddanapudi
August 2020, 36(5):85-91
The COVID-19 pandemic has posed unprecedented challenges and has unique implications for pediatric anesthesiologists. While children have a less severe clinical course compared to adults, they might be an important component in the transmission link by being asymptomatic carriers. Thus, it is essential to have practice guidelines for pediatric health care providers to limit transmission while providing safe and optimum care to our patients. Here we provide a brief review of the unique epidemiology and clinical characteristics of COVID-19 inflicted children. We have also reviewed various pediatric anesthesia guidelines and summarized the same to provide insight into the goals of management. We share the protocols that have been formulated and adopted in the pediatric anesthesia wing of our tertiary care hospital. This article lays special emphasis on the preparation of specialized protocols, designated areas, and training of personnel expected to be involved in patient care. The operating room should be well equipped with weight and age-appropriate equipment and drugs. Special attention should be paid to minimize aerosol generation via premedication and physical barriers. Induction and airway handling should be performed rapidly and securely with minimum personnel present. Disconnections should be avoided during maintenance. Extubation and transfer of children should be smooth. These protocols and guidelines are being constantly reviewed and updated as new evidence emerges. Our goal as pediatric anesthesiologists is to provide anesthesia that is safe for the child while preventing and minimizing the risk of infection to health care workers.
  - 1,393 246
Emergency neurological procedures during COVID-19 pandemic: Practical issues
Gyaninder Pal Singh, Ajay Prasad Hrishi, Girija Prasad Rath
August 2020, 36(5):104-109
The novel coronavirus disease 2019 (COVID-19) has emerged as a global pandemic. A significant number of these patients would present to hospitals with neurological manifestations and neurosurgical emergencies requiring urgent treatment. The anesthesiologists should be prepared to manage these cases in an efficient and timely manner in the operating room, intensive care units, and interventional neuroradiology suites. The clinical course of the disease is in an evolving stage. As we acquire more knowledge about COVID-19, new recommendations and guidelines are being formulated and regularly updated. This article discusses the anesthetic management of urgent neurosurgical and neurointerventional procedures. In addition, a brief overview of intrahospital transport of neurologically injured patients has been addressed.
  - 1,064 152
Trauma care and COVID-19 pandemic
Chhavi Sawhney, Yudhyavir Singh, Kajal Jain, Ravindra Sawhney, Anjan Trikha
August 2020, 36(5):115-120
The Coronavirus SARS- CoV-2 (COVID-19) pandemic has overwhelmed the ability of health care systems all over the world. With the spread of the disease, countries have adopted different models to reorganize infrastructure and reallocate the resources to deal with the pandemic. All the nonurgent hospital services have been postponed. But, trauma and emergency services continue to function according to the established protocols with few modifications. During the pandemic, trauma care is based on clinical urgency, safety of the patient as well as health care workers (HCWs) and conservation of resources. The strategies include non-operative management if possible, restricting the number of personnel and utilization of remote consultation or telemedicine. In the present article, we discuss the triage and management of trauma victim during the pandemic, indications for emergency surgery and psychological impact of the pandemic. We also discuss the future challenges during the post-COVID-19 phase.
  - 2,202 292
Lessons learned from first case of Cesarean delivery in a COVID-19 positive parturient in Greek region
Chrysanthi Batistaki, Vasiliki Galarioti, Sofia Vasiliadou, Eleftheria Soulioti, Georgia Kostopanagiotou, Paraskevi Matsota
August 2020, 36(5):121-124
We report the successful anesthetic management of a 24-year-old patient, with an active COVID-19 viral infection, scheduled for elective Cesarean section at 40th week of pregnancy. This was the first case in Greek region, and we report and discuss the difficulties and safety issues regarding a COVID-19 positive patient during an elective cesarean delivery. Regional anesthesia with full protective equipment for health personnel involved, along with careful planning and adherence to guidelines achieved safe completion of the operation.
  - 1,167 164
Solid-organ transplant surgeries in era of COVID-19 pandemic: How to go about it?
Divya Srivastava, Sohan Lal Solanki, Abhilash Chandra
August 2020, 36(5):125-126
  - 857 119
Anesthesia for oral surgeries during the COVID-19 pandemic
Sheila N Myatra, Sushan Gupta, Prathamesh S Pai
August 2020, 36(5):96-104
The severe acute respiratory syndrome corona virus 2(SARS-Cov2) virus replicates in the nasal cavity, nasopharynx, and the oropharynx. During oral surgery, the risk of viral transmission is high during instrumentation in these areas, while performing airway management procedures, the oral surgery itself, and related procedures. During the corona virus disease 2019 (COVID-19) pandemic, patients with an oral pathology usually present for emergency procedures. However, patients with oral cancer, being a semi-emergency, may also present for diagnostic and therapeutic procedures. When elective surgeries are resumed, these patients will come to the operating room. In asymptomatic patients, the false-negative rate can be as high as 30%. These patients are a source of infection to the healthcare workers and other patients. This mandates universal precautions to be taken for all patients presenting for surgery. Lesions along the airway, distorted anatomy secondary to cancer therapy, shared airway with the surgeon, surgical handling of the airway and the risk of bleeding, make airway management challenging in these patients, especially while wearing personal protective equipment. Airway management procedures, oral surgery, use of cautery, and other powered surgical instruments in the aero digestive tract, along with constant suctioning are a source of significant aerosol generation, further adding to the risk of viral transmission. Maintaining patient safety, while protecting the healthcare workers from getting infected during oral surgery is paramount. Meticulous advance planning and team preparation are essential. In this review, we discuss the challenges and recommendations for safe anesthesia practice for oral surgery during the COVID-19 pandemic, with special emphasis on risk mitigation.
  - 1,341 200
Combating the COVID-19 battle with personal protective equipment (PPE) armamentarium
Sukhminder Jit Singh Bajwa, Madhuri Kurdi, Naveen Malhotra
August 2020, 36(5):133-136
  - 849 130
Ancillary protective gears in the COVID- 19 Era
Divya Jain, Rakesh Kumar
August 2020, 36(5):136-138
  - 794 98
Need of guidelines for safe transport of patients with COVID-19
Rohini Dattari, Rakesh Garg
August 2020, 36(5):139-141
  - 750 199
Endoscopy mask for safe extubation in patients with COVID-19
Renu Sinha, Souvik Maitra, Bikash Ranjan Ray
August 2020, 36(5):155-157
  - 689 117
Reducing the viral load while securing the airway
Mukul Chandra Kapoor
August 2020, 36(5):147-148
  - 739 97
A simple and novel technique for facial protection during anesthesia administration in a suspected or positive COVID-19 patient
Ravindra Sisodia, Shubham Khandelwal
August 2020, 36(5):148-150
  - 893 95
Peripartum cardiomyopathy mimicking COVID-19 infection
Shaloo Garg, Archana Singh, Mukesh Kalita, Ayesha Zafar Siddiqui, Mukul Chandra Kapoor
August 2020, 36(5):44-47
A pregnant patient presented with fever and desaturation, without breathlessness. She was suspected to have COVID-19 but SARS-CoV-2 was negative. She developed fetal distress and underwent an uneventful Cesarean section. Postoperatively, she developed respiratory distress and needed mechanical ventilation support. The clinical features suggested COVID-19 infection and antiviral treatment were empirically initiated. Repeat SARS-CoV-2 was negative. Echocardiography, computed tomography scans, and biochemical investigations supported a diagnosis of peripartum cardiomyopathy. She was successfully managed with decongestive therapy and could be discharged home on the fifth day.
  - 836 146
Comorbidities and COVID-19
Lakshmi Narayana Yaddanapudi
August 2020, 36(5):18-20
  - 808 155
Intensive care management of patients with COVID-19
Anjan Trikha, Akhil Kant Singh, Puneet Khanna
August 2020, 36(5):29-38
The COVID-19 pandemic originated in China in December 2019 and has since then, swept across the world. The last Influenza pandemic of 1918 happened before the advent of modern medicine. We have come a long way since then. But the pandemic has still caught us unprepared in many quarters. The review focuses on the management of critically ill COVID-19 patients and the various challenges faced by intensivists.
  - 1,956 293
COVID-19 cardiopulmonary resuscitation: Guidelines and modifications
Pankaj Kundra, Stalin Vinayagam
August 2020, 36(5):39-44
International societies like the International Liaison Committee on Resuscitation (ILCOR), American Heart Association (AHA), and UK Resuscitation Council have suggested modified guidelines for resuscitation during coronavirus disease (COVID-19) pandemic. Though there is consensus in most of the recommendations there are also disparities. Considering the rapidly evolving COVID-19 pandemic and our better understanding of the spread of the disease, there is an urgent need to suggest modifications to the existing guidelines. These modifications should allay the fear of health care workers regarding their safety and reluctance to provide cardiopulmonary resuscitation (CPR) but should also address the serious concerns where an opportunity is lost to revive patients who may not be COVID positive as suspected.
  - 6,073 505