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Tube obstruction is one of the common complications of tracheostomy. The most frequent cause of tube obstruction is the plugging of tracheostomy tube with mucous plug, clots, or crust. We report a case of low tracheostomy obstructed by a mass of subcutaneous tissue proliferating into the tracheal lumen. When the patient was posted for radical surgery, trachea was cannulated using a regular endotracheal tube (ETT) inserted into the stoma under fiber optic bronchoscope guidance, and general anesthesia was administered. Anatomically distorted tracheostomy tracts may be maintained with customized tracheostomy tubes if available to prevent complications. Any difficulty in inserting tracheostomy tube can be temporarily managed with the ETT inserted into the stoma.

Objectives: This study is designed to evaluate the cardioprotective effect of fenugreek on isoproterenol- induced myocardial infarction and is investigated by an in vivo method in rats. Materials and Methods: Male Wistar albino rats were divided into four groups (n=10). Group I received 0.5% CMC treated as normal control group. Group II received isoproterenol (85 mg/kg body weight) intraperitoneal (i.p.) for two consecutive days (14th and 15th days). Group III received fenugreek (250 mg/kg body weight) intragastric intubation for 15 days. Group IV rats received fenugreek as in Group III and additionally isoproterenol was given for two consecutive days (14th and 15th days). Results: The results described the cardioprotective effect that observed in Group IV showed significantly (P< 0.05) decreased levels of TBARS and enhanced the activities of both enzymatic and non-enzymatic antioxidants (SOD, CAT, GPx and GSH) in myocardial infarcted rats when compared to Groups II and III. Histopathological studies were also co-relating with the above biochemical parameters. Conclusion: These findings concluded the cardioprotective effect of fenugreek on lipid peroxidation and antioxidant defense system during isoproterenol-induced myocardial infarction in rats.