Publications by authors named "Jyoti Burad"

12 Publications

  • Page 1 of 1

Super Refractory Status Epilepticus in Hashimoto's Encephalopathy.

Oman Med J 2017 May;32(3):247-250

Department of General Medicine, Sultan Qaboos University Hospital, Muscat, Oman.

We present a case of a 38-year-old woman who was at eight weeks of gestation and was admitted to Sultan Qaboos University Hospital with refractory status epilepticus (SE). She presented with a two-day history of fever and a depressed level of consciousness that was followed with generalized tonic-clonic seizures. She progressed to refractory SE that required intubation and mechanical ventilation. Autoimmune workup was suggestive of Hashimoto's encephalopathy (HE) as suggested by the high levels of thyroid antibodies. Her magnetic resonance imaging showed bilateral hippocampal and basal ganglia hyperintensities, and electroencephalogram showed bilateral frontal epileptiform discharges. Other autoimmune workup was negative. Intravenous anesthetics were started including propofol, midazolam, ketamine, and thiopentone. She was started on multiple immunosuppressive therapies. Multiple antiepileptics were used including phenytoin, lamotrigine, levetiracetam, sodium valproate, clobazam, phenobarbital, and lacosamide. The outcome was unusual in terms of refractoriness to immunotherapy treatment despite a confirmed diagnosis. We did a literature review of all cases with HE presenting with SE with their clinical characteristics and outcome.
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http://dx.doi.org/10.5001/omj.2017.46DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447801PMC
May 2017

Quick diagnosis of venous air embolism.

Intensive Care Med 2017 05 19;43(5):700-701. Epub 2017 Jan 19.

Department of Anesthesia and Intensive Care, Sultan Qaboos University Hospital, P.O. Box 123, PC 38, Al Khod, Muscat, Oman.

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http://dx.doi.org/10.1007/s00134-016-4660-5DOI Listing
May 2017

Comparison of conventional and ultrasound guided techniques of radial artery cannulation in different haemodynamic subsets: a randomised controlled study.

Intensive Care Med 2017 Jan 29;43(1):140-141. Epub 2016 Sep 29.

Department of Anesthesia and Intensive Care, Sultan Qaboos University Hospital, Muscat, Oman.

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http://dx.doi.org/10.1007/s00134-016-4569-zDOI Listing
January 2017

Avoidance of Laryngeal Injuries during Gastric Intubation.

Sultan Qaboos Univ Med J 2014 Aug 24;14(3):e405-8. Epub 2014 Jul 24.

Department of Anaesthesia & Intensive Care, Sultan Qaboos University Hospital, Muscat, Oman.

Gastric intubation is a common and simple procedure that is often performed on patients who are sedated or anaesthetised. If the gastric tube (GT) is inserted blindly while the patient is unconscious, this procedure may result in easily preventable complications such as laryngeal trauma. We present an interesting case where the blind placement of a orogastric tube (OGT) in an anesthetised 52-year-old female patient at Sultan Qaboos University Hospital in Oman resulted in significant arytenoid trauma. This led to delayed tracheal extubation. The movement of the GT from the oropharyngeal area to the upper oesophageal sphincter can be visualised and controlled with the use of Magill forceps and a laryngoscope. Therefore, this report highlights the need for GT insertion procedures to be performed under direct vision in patients who are unconscious (due to sedation, anaesthesia or an inherent condition) in order to prevent trauma to the laryngeal structures.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117670PMC
August 2014

Safe removal of epidural catheter--a dilemma, in patients who are started on dual anti platelet therapy postoperatively for acute coronary syndrome--a case report.

Middle East J Anaesthesiol 2012 Oct;21(6):905-8

Department of Anesthesia and ICU, Sultan Qaboos University Hospital, Muscat. P.O. Box: 239, PC 115, Madinat Qaboos, Muscat, Oman.

Epidural catheter insertion or removal in patients receiving antiplatelet therapy for acute coronary syndrome poses a high risk for epidural hematoma. Though practice guidelines suggest stopping clopidogrel for at least 7 days before such intervention. Withholding anti-platelet drugs for such a long duration represents a great risk to these patients. We present a case of a 53 year old male patient who underwent an exploratory laparotomy. He had an epidural catheter inserted for analgesia. He developed acute myocardial infarction on the first postoperative day, which was treated with dual antiplatelet therapy and percutaneous coronary angioplasty. The removal of epidural catheter in this patient required a clinical decision, balancing the risk of epidural hematoma with continuation of antiplatelet therapy against the risk of coronary re-thrombosis with discontinuation of the medication. We followed a strategy that combined a short duration of discontinuation of therapy, assessment of platelet functions by laboratory test, transfusion of platelets and removal of catheter, followed by restart of anticoagulation, which proved safe for the patient.
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October 2012

Adult Sickle Cell Disease: A Five-year Experience of Intensive Care Management in a University Hospital in Oman.

Sultan Qaboos Univ Med J 2012 May 9;12(2):177-83. Epub 2012 Apr 9.

Departments of Anaesthesia & Intensive Care and.

Objectives: Sickle cell disease (SCD) is an inherited disease caused by an abnormal type of haemoglobin. It is one of the most common genetic blood disorders in the Gulf area, including Oman. It may be associated with complications requiring intensive care unit (ICU) admission. This study investigated the causes of ICU admission for SCD patients.

Methods: This was a retrospective analysis of all adult patients ≥12 years old with SCD admitted to Sultan Qaboos University Hospital (SQUH) ICU between 1st January 2005 and 31st December 2009.

Results: A total number of 49 sickle cell patients were admitted 56 times to ICU. The reasons for admission were acute chest syndrome (69.6%), painful crises (16.1%), multi-organ failure (7.1%) and others (7.2%). The mortality for SCD patients in our ICU was 16.1%. The haemoglobin (Hb) and Hb S levels at time of ICU admission were studied as predictors of mortality and neither showed statistical significance by Student's t-test. The odds ratio, with 95% confidence intervals, was used to study other six organ supportive measures as predictors of mortality. The need for inotropic support and mechanical ventilation was a good predictor of mortality. While the need for non-invasive ventilation, haemofiltration, blood transfusions and exchange transfusions were not significant predictors of mortality.

Conclusion: Acute chest syndrome is the main cause of ICU admission in SCD patient. Unlike other supportive measures, the use of inotropic support and/or mechanical ventilation is an indicator of high mortality rate SCD patient.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3327564PMC
http://dx.doi.org/10.12816/0003110DOI Listing
May 2012

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.

Indian J Anaesth 2012 Jan;56(1):69-71

Department of Anaesthesia and Intensive Care, Sultan Qaboos University Hospital, Muscat, Oman.

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.
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http://dx.doi.org/10.4103/0019-5049.93349DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3327077PMC
January 2012

Development of acute ischemic stroke in a patient with acute respiratory distress syndrome (ARDS) resulting from H1N1 pneumonia.

Acta Anaesthesiol Taiwan 2012 Mar 27;50(1):41-5. Epub 2012 Mar 27.

Department of Anesthesia and Intensive Care, Sultan Qaboos University Hospital, Muscat, Oman.

Pneumonia due to H1N1 infection is now very common. We report a case of ischemic stroke which arose subsequently to H1N1 influenza. The patient was a female who developed acute respiratory distress syndrome (ARDS) after H1N1 influenza, was ventilated as per standard protocol and started treatment with oseltamivir. When sedation was stopped during weaning from the ventilator, she was found to have left hemiparesis resulting from multiple infarctions in the brain. Contrary to thrombocytosis usually seen in acute influenza, the platelet counts in our patient actually dropped. We suspected that increased interleukin release or stickiness of the platelets might have caused this ischemic stroke. In the course of time, she had acceptable neurological recovery following treatment with aspirin and neuro-rehabilitation. This case report provides evidence that a rare, debilitating complication like stroke can occur in H1N1 infection. A high index of suspicion of the probability of a cerebrovascular event should be borne in mind and regular neurological assessment should be done in such cases.
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http://dx.doi.org/10.1016/j.aat.2012.02.002DOI Listing
March 2012

Sudden near-fatal tracheal aspiration of an undiagnosed nasal foreign body in a small child.

Emerg Med Australas 2011 Dec;23(6):776-8

Department of Anesthesiology, Sultan Quaboos University Hospital, Muscat, Oman.

Foreign body aspiration is a commonly encountered emergency in children. Foreign body can lodge in any site from supra-glottis to the terminal bronchioles. Symptoms might range from none to respiratory compromise, cardiac arrest and even death depending on location and size. We report successful management of a child who aspirated a nasal foreign body during physical examination in an outpatient department causing complete airway obstruction with special mention about different management options available for managing near total respiratory arrest from an aspirated foreign body in the ED.
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http://dx.doi.org/10.1111/j.1742-6723.2011.01471.xDOI Listing
December 2011

Complications of Central Venous Catheterisation: Breakage of guidewire-a disaster averted.

Sultan Qaboos Univ Med J 2011 Nov 25;11(4):519-21. Epub 2011 Oct 25.

Department of Anaesthesia & ICU, Sultan Qaboos University Hospital, Muscat, Oman;

Central venous catheterisation (CVC) is a common bedside invasive procedure done in medical practice. Even though it is a safe procedure when done with ultrasound guidance, difficulties and complications do occur even in experienced hands. Here, we describe the difficulties encountered in the form of the breakage of the guidewire while inserting a CVC in a patient with sickle cell disease.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206758PMC
November 2011

Anaesthetic management of a patient with Weill-Marchesani syndrome complicated with mitral regurgitation.

Indian J Anaesth 2011 Jul;55(4):428-30

Department of Anaesthesia and Intensive Care, Sultan Qaboos University and Hospital, Muscat, Oman.

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http://dx.doi.org/10.4103/0019-5049.84831DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190534PMC
July 2011