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Pericardial tamponade limits diastolic filling of the heart; therefore, a high venous pressure is required to fill the ventricle. In presence of cardiac tamponade, therapeutic agents and manoeuvres that results in venodilation or vasodilation can severely compromise diastolic filling of the heart and might result in rapid cardiac decompensation. Equalization of central venous pressure and pulmonary artery diastolic pressure or equalization of pressures in all four chambers during diastole confirms cardiac tamponade. Transthoracic echocardiography can detect the site of tamponade and assist in pericardiocentesis. We describe acute pericardial tamponade in a young man who underwent left posterolateral thoracotomy for left upper lobectomy. Intraoperatively, mobilization of the left upper lobe was frequently associated with hypotension. Postoperatively, the patient suffered two more episodes of hypotension. The episodes of hypotension were attributed to surgical manipulation and epidural blockade. Hemodynamics normalized after discontinuing epidural infusion, volume resuscitation and lobectomy. On third postoperative day, the patient developed cardiovascular collapse; arterial blood pressure and central venous pressure were 70/50 and 12 mmHg. Investigations showed haziness of left lung, and severe respiratory acidosis. On opening of the left thoracotomy wound, pericardial tamponade was diagnosed. A pericardial window was created and tamponade was released with that the hemodynamics normalized. Episodes of unexplained hypotension after left upper lobectomy suggest a cardiac etiology and acute pericardial tamponade is a possibility which should be released immediately otherwise it can result in fatal outcome.

Bidirectional superior cavopulmonary shunt (bidirectional Glenn shunt) is generally performed in many congenital cardiac anomalies where complete two ventricle circulations cannot be easily achieved. The advantages of BDG shunt are achieved by partially separating the pulmonary and systemic venous circuits, and include reduced ventricular preload and long-term preservation of myocardium. The benefits of additional pulsatile pulmonary blood flow include the potential growth of pulmonary arteries, possible improvement in arterial oxygen saturation, and possible prevention of development of pulmonary arteriovenous malformations. However, increase in the systemic venous pressure after BDG with additional pulsatile blood flow is known. We describe the peri-operative implications of severe flow reversal in the superior vena cava after pulsatile BDG shunt construction in a child who presented for surgical interruption of the main pulmonary artery.

Acute lung collapse during open-heart surgery may potentially lead to problems such as inadequate gas exchange, increased pulmonary vascular resistance, increased afterload to the right ventricle, and difficulty in weaning from cardiopulmonary bypass (CPB). Therefore, expansion of the lungs is ensured prior to separation from CPB. We report the inability to manually expand a chronically collapsed lung during the repair of ascending aortic aneurysm. The collapsed lung did not pose difficulty in separation from CPB and in blood gas management during the perioperative period. We discuss perioperative management issues in such situations.

A patent ductus arteriosus (PDA) is often present in patients undergoing correction of congenital heart disease. It is well appreciated that during cardiopulmonary bypass (CPB), a PDA steals arterial inflow into pulmonary circulation, and may lead to systemic hypoperfusion, excessive pulmonary blood flow (PBF) and distention of the left heart. Therefore, PDA is preferably ligated before initiation of CPB. We describe acute decreases of arterial blood pressure and entropy score with the initiation of CPB and immediate increase in entropy score following the PDA ligation in a child undergoing intracardiac repair of ventricular septal defect and right ventricular infundibular stenosis. The observation strongly indicates that a PDA steals arterial inflow into pulmonary circulation and if the PDA is dissected and ligated on CPB or its ligation on CPB is delayed the cerebral perfusion is potentially compromised.

The repair of abdominal aortic aneurysm (AAA) in the presence of significant coronary artery disease (CAD) carries a high-risk of adverse peri-operative cardiac event. The options to reduce cardiac risk include perioperative β-blockade, preoperative optimization by myocardial revascularization and simultaneous (combined) coronary artery bypass grafting and aneurysm repair. We describe intra-operative controlled phlebotomy to optimize myocardial stress during repair of infrarenal AAA in a patient with significant stable CAD.

This study investigates the reproductive seasonality variation in Indian Major Carps (IMC), specifically Rohu (Labeo rohita) and Catla (Labeo catla). Utilizing field observations and analysis of gonadosomatic index (GSI), distinct reproductive patterns were observed among these species. The findings highlight that, in the absence of scientific interventions such as photoperiod manipulation and feeding management, a significant portion of Rohu and Catla fish reach maturity and breed after and before monsoon period (December and March). Understanding these reproductive variations is crucial for the identification of genetically distinct stocks suitable for line development that can reproduce during the winter seasons. This knowledge contributes to the strategic management of year-round seed availability. By elucidating the natural reproductive cycles of these economically important species, researchers can optimize breeding programs to align with environmental conditions, potentially identifying genetically different stock for line development, which can breed during winter seasons. [ABSTRACT FROM AUTHOR]

Anesthetic management of intracranial arteriovenous malformation (AVM) poses multiple challenges to the anesthesiologist in view of its complex and poorly understood pathophysiology and multiple modalities for its treatment involving different [...]

Byline: Georgene. Singh, Ari. Manickam, Manikandan. Sethuraman, Ramesh. Rathod We describe a case of Takotsubo cardiomyopathy in a case of pituitary macroadenoma in acute adrenal crisis. A 48-year-old man presented [...]

Byline: Prabhat. Sinha, Thomas. Koshy, P. Gayatri, V. Smitha, Mathew. Abraham, Ramesh. Rathod Context: Awake craniotomy is increasingly performed the world over. We share our experience of performing craniotomy awake [...]

The 2D few-layered Ti 3 C 2 T x MXene nanosheets have been prepared by etching and delamination of aluminium layers from the Ti 3 AlC 2 MAX phase. The electroactive polyamide (EPA)/Ti 3 C 2 T x MXene nanocomposites (NCs) containing (0.6, 1.2 and 1.8 wt%) MXene were prepared via in-situ oxidative coupling polymerization. The structural properties of NCs indicated close interaction between EPA and MXene resulting in improvement in physical properties such as electrical conductivity, thermal stability and adhesion strength. The surface roughness and water contact angle were not affected by the addition of Ti 3 C 2 T x MXene in the EPA matrix. The tribological properties were improved for NCs coated samples. The corrosion study revealed the excellent corrosion protection ability of EPA/Ti 3 C 2 T x MXene NCs containing 1.2 wt% MXene. [Display omitted] • Preparation of a few-layered Ti 3 C 2 T x MXene nanosheet via etching and delamination process. • Preparation of EPA@Ti 3 C 2 T x MXene nanocomposites containing different wt.% of Ti 3 C 2 T x MXene by the in-situ polymerization process. • The EPA@Ti 3 C 2 T x MXene nanocomposites were studied in terms of structural, physical, wear and anticorrosive properties. • The EPA@Ti 3 C 2 T x MXene nanocomposite coating containing 1.2 wt.% of Ti 3 C 2 T x MXene exhibited outstanding anticorrosive properties. [ABSTRACT FROM AUTHOR]