Abstract: Aim: To compare the ease of lung isolation using a double-lumen tube (DLT) versus a bronchial blocker (BB) in terms of the number of attempts, need for bronchoscope assistance, and incidence of airway trauma in patients undergoing thoracic surgery.

Materials &Methods: This prospective observational study included 100 patients aged 18–65 years undergoing elective thoracic surgery requiring lung isolation. Patients were randomized into two groups: Group DLT (n = 50) underwent lung isolation with a double-lumen tube, and Group BB (n = 50) with a bronchial blocker. General anesthesia with a standardized protocol was administered, and procedures were performed by experienced anesthesiologists. Outcome measures included the number of attempts required for successful lung isolation, bronchoscope usage, and airway trauma assessed immediately and 24 hours postoperatively. Data were analyzed using Student’s t-test and chi-square tests, with p-values <0.05 considered significant.

Results: Group DLT achieved significantly higher first-attempt success rates (90.0% vs. 74.0%, p = 0.04) and required fewer attempts (1.10 ± 0.30 vs. 1.32 ± 0.56, p = 0.03). Bronchoscope use was less frequent in Group DLT (24.0% vs. 82.0%, p < 0.001), with shorter bronchoscope time (3.5 ± 1.2 min vs. 6.8 ± 1.6 min, p < 0.001). Airway trauma was more common in Group BB (36.0% vs. 18.0%, p = 0.03), and Group DLT had significantly shorter procedure times (8.2 ± 2.1 min vs. 11.5 ± 3.2 min, p < 0.001). Patient and surgeon satisfaction scores were significantly higher in Group DLT.

Conclusion: Double-lumen tubes (DLTs) are more efficient and reliable than bronchial blockers (BBs) for lung isolation, with higher first-attempt success rates, reduced bronchoscope dependence, shorter procedure times, and lower airway trauma rates. DLTs are better suited for routine thoracic surgeries, while BBs remain valuable for specific scenarios requiring flexible approaches.

The research is based on a collection of information that allows characterizing the leadership in learning management in the Educational Units of the city of Chone: Cinco de Mayo, Eugenio Espejo, Raymundo Aveiga, Oswaldo Castro Intriago, Augusto Solórzano Hoyos and Santa Mariana de Jesús. From this perspective, its significance is weighed, given that the implementation of data collection instruments allowed determining the current state of leadership in learning management in the Educational Units in the city of Chone. The objective is to investigate the current state of Leadership in learning management in the institutions studied. Field work was used as a methodology, organized to collect information through a survey using the Google form platform. The result was that the educational units exercise leadership is not fully understood by the students, as there is no majority of criteria as there are students who do not perceive it as institutional leadership.

Abstract: Aim: This study aimed to evaluate the efficacy and safety of ultrasound-guided stellate ganglion block (SGB) for the relief of post-traumatic stress disorder (PTSD) symptoms in patients with treatment-resistant PTSD.

Materials & Methods: This prospective observational study included 50 patients aged 18–65 years, diagnosed with PTSD based on DSM-5 criteria. Patients with persistent PTSD symptoms despite psychotherapy or pharmacotherapy were included, while those with coagulopathy, local infections, allergies to anesthetics, or severe comorbidities were excluded. Bilateral SGB was performed under ultrasound guidance, using a 22-gauge needle and injecting 6 mL of 0.25% bupivacaine. The procedure was repeated on the contralateral side after 7 days. Outcomes were assessed using the Clinician-Administered PTSD Scale (CAPS-5), Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7) scale, and Global Assessment of Functioning (GAF) at baseline, 2 weeks, 1 month, 3 months and 6 months.

Results: The study included 50 patients (mean age 38.2 ± 10.4 years, 60% male), all of whom had prior psychotherapy and 80% had received pharmacotherapy. Significant reductions in PTSD symptoms (CAPS-5 scores from 47.6 ± 8.2 to 24.5 ± 5.2 at 6 months, p < 0.01), sleep disturbances (PSQI scores from 14.2 ± 3.1 to 7.6 ± 2.1, p < 0.01), and anxiety levels (GAD-7 scores from 15.8 ± 4.6 to 7.4 ± 3.1, p < 0.01) were observed. Functional improvement (GAF scores from 45.7 ± 7.5 to 69.7 ± 8.8, p < 0.01) and high satisfaction levels were reported. Adverse events were minimal and included local pain (10%), mild dizziness (6%), and transient hoarseness (4%). No serious complications occurred.

Conclusion: Ultrasound-guided SGB demonstrated significant efficacy in reducing PTSD symptoms, improving sleep quality, and alleviating anxiety, with sustained benefits up to three months. The procedure was well-tolerated, with a low incidence of minor adverse effects, making it a safe and effective adjunctive treatment for treatment-resistant PTSD.

Reflex anoxic seizures (RAS) are a unique type of seizure that can present as life-threatening events, primarily affecting preschool children but also occurring in older individuals. Characterized by a vagally mediated response to noxious stimuli, RAS leads to bradycardia and potential asystole, resulting in cerebral hypoperfusion and hypoxia. This case report details a 20-year-old female patient with a history of RAS presenting for a routine molar tooth extraction under anesthesia. After years of misdiagnosis as epilepsy, her seizures were attributed to RAS, leading to the cessation of antiepileptic medication without increased seizure frequency. During her dental procedure, a series of preventative measures were implemented to ensure a safe anesthetic experience, including patient education, careful monitoring, and the availability of atropine and other interventions. The procedure was uneventful, and the patient was discharged as planned. This case highlights the importance of recognizing RAS in the perioperative setting and the steps that can be taken to mitigate risks during anesthesia.

Abstract: Background: Eclampsia is the term used to describe preeclampsia that is complicated by widespread tonic-clonic seizures. The present study was conducted to assess perinatal outcome in eclampsia patients.

Materials & Methods: 58 women presenting with antepartum and intrapartum eclampsia were selected. Obstetrics characteristics, gestational age, mode of delivery, intensive care unit admission, time of eclampsia in relation to labour and maternal and foetal complications were recorded.

Results: The mode of delivery was caesarean sectionsin 42, vaginal deliveryin 10 and instrumental deliveries in 6 cases. The difference was significant (P< 0.05). There were 8 primi very preterm babies, 7 primi moderate preterm, 18 primi and 4 multi late preterm, 16 primi and 2 multi early term and 2 primi and 1 multi full term babies. The difference was significant (P< 0.05). Perinatal outcome was birth asphyxia in 12, low birth weightin 32, IUD in 6 and SNCU admission in 7 babies. Maternal outcome had pulmonary edema in 4, HELLP in 2, abruptio placentae in 3 and cardiomegaly in 1 case.

Conclusion: Mass education about the value of ANC checkups for early diagnosis and prevention of eclampsia is necessary because eclampsia is a preventable condition if preeclampsia is identified by ANC. Predisposing factors include nulliparity, delayed referral, inadequate transportation, lack of understanding, and irregular ANC checkups.

Background: Hip fracture contributes to both morbidity and mortality. Hence; the present study was conducted for assessing the outcome of intertrochanteric fractures of femur managed by proximal femoral nail Antirotation (PFN-A).

Materials & Methods: 20 patients with intertrochanteric fracture of femur were enrolled. Complete demographic and clinical details of all the patients was obtained. Blood samples were obtained and hematological along with biochemical profile was evaluated. All the patients underwent surgical treatment by PFN-A. Outcome was evaluated using the Harris Hip Score (HHS). All the results were recorded in Microsoft excel sheet and were subjected to statistical analysis using SPSS software.

Results: A total of 20 patients were assessed. Mean HHS among patients at baseline, 3 months follow-up and 6 months follow-up was 39.5, 63.3 and 77.9 respectively.

Conclusion: Hip fractures can affect individuals across all age groups; however, they are notably more prevalent among the elderly, particularly those with osteoporosis, as a result of low-energy mechanisms. PFN-A is good option for managing patients with intertrochanteric fracture of femur.