Bhavya Krishna

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Verified

Bhavya verified their affiliation via an institutional email.

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• MD Anesthesiology
• Professor (Assistant) at Vardhman Mahavir Medical College and Safdarjung Hospital

Background and Aims Provision of adequate perioperative analgesia in children is important to attenuate the stress response to surgery. Caudal analgesia using local anesthetics is a traditionally used technique but provides a limited duration of analgesia. Several adjuvants can be added to local anesthetics to increase the duration of action. This...

Background and aims: The coronavirus disease-2019 (COVID-19) pandemic has grappled the entire globe since the beginning of 2020. In India, two vaccines were released in January 2021, the Covaxin® and the Covishield™. However, despite vaccination, many breakthrough infections were reported during the second wave in India. The present cross-sectiona...

Background We studied the incidence of magnesium (Mg) disturbances in patients admitted to a multidisciplinary intensive care unit (ICU) and correlated serum magnesium levels with clinical outcomes. Materials and methods The study was conducted on 280 critically ill patients aged above 18 years and admitted to the ICU. Serum magnesium levels at ad...

Pheochromocytomas are rare adrenal tumors that produce excessive catecholamines and their surgical removal poses significant risks of intraoperative hemodynamic instability (HI) due to catecholamine release. This review article discusses the perioperative factors that impact hemodynamic lability and its management in patients undergoing surgical re...

Background Supraglottic airway devices (SADs) have emerged as an alternative for airway management, serving as conduits for tracheal intubation with fibreoptic bronchoscopy (FOB). In this study, we aim to compare the efficacy of two SADs for FOB guided tracheal intubation in adult patients undergoing elective surgery. Methods 120 patients were ran...

Introduction- Endovascular treatment of intracerebral aneurysms/arteriovenous malformations requires the neuro-anaesthesiologist to control and manipulate the haemodynamic parameters with minimum fluctuations. The aim of this study was to compare the performance of endotracheal intubation versus Laryngeal Mask Airway (LMA) ProSeal with respect to h...

Objectives Thyroid surgery is a painful procedure for which bilateral superficial cervical plexus block (BSCPB) can be given to potentially reduce postoperative pain. Ultrasound guidance provides real-time visualization of anatomical structures, needle movement, and accurate deposition of local anesthetic in close proximity to nerves, thus making t...

A BSTRACT Background Nutritional risk in patients with coronavirus disease (COVID-19) admitted in intensive care units (ICU) is less researched. We planned a prospective trial to determine the utility of Nutritional risk in the Critically ill (NUTRIC) and modified NUTRIC (mNUTRIC) scores in such cases. Materials and Methods Patient characteristic...

Introduction COVID-19 is primarily a pulmonary disease, but with significant and frequent systemic manifestations. Our study aims to assess, which scoring system on admission—Confusion, Uraemia, Respiratory Rate > 30/min, Blood Pressure low, Age > 65 years (CURB-65) or SOFA, better correlates with COVID-19-positive patient mortality. Methodology T...

We report this case to emphasize the need for considering the use of CPAP in neonates to tide over periods of acute respiratory distress in the postextubation period in thoracic surgeries (like lobectomy) to prevent re-intubations.

Malignant nasal melanomas, arising due to uncontrolled proliferation of melanocytes, are among the rarest head-and-neck tumors. The rare nature and presentation of this disease may pose many other anesthetic challenges that currently unknown. To the best of our knowledge, no published report is available regarding the anesthetic management of this...

Background Lung ultrasound (LUS) is a simple bedside tool to assess overhydration. Our study aimed to assess extravascular lung water (EVLW) using B-lines and correlate it with weaning, duration of mechanical ventilation, and mortality in critically ill patients admitted to the intensive care unit (ICU). Patients and methods 150 mechanically venti...

Ischemic necrosis of the bulbar urethra in a patient with pelvic fracture urethral injury without a prior history of surgical intervention is extremely rare and results in long-segment obliterative strictures that are difficult to manage. Instead of the more traditional approach of vascular reconstruction followed by transpubic end-to-end urethropl...

Background: The world has seen multiple peaks and troughs due to various strains of SARS-CoV-2 virus since December 2019. We present the epidemiology, clinical and laboratory profile of critically ill patients infected with omicron strain during the third wave in a tertiary care ICU setup in New Delhi. Methods: This was a prospective observational...

Giant renal tumors filling the entire abdominal cavity are rare in adolescents and pose a surgical challenge. Unlike their pediatric counterparts, where upfront chemotherapy can be administered without histologic confirmation, management of a giant renal tumour in adolescents follows that of the adults and is primarily surgical. Herein, we report a...

Infants with a history of prematurity, craniofacial abnormality, apnoeic spells, developmental delay and obstructive sleep apnea are at a greater risk for opioid-induced respiratory events. Therefore, adopting opioid-free or opioid-sparing techniques for safer perioperative care in infants is essential. We used opioid-sparing multimodal analgesia w...

Trauma care in Musculoskeletal and Spine Trauma

Background Anesthesia in post-pneumonectomy patients is challenging as pneumonectomy is considered “a disease itself” with impaired oxygenation and ventilation. Literary data for prone ventilation in post-pneumonectomy patients is scarce. Case presentation A 45-year-old female patient with a history of right-sided pneumonectomy 10 years ago with r...

Pheochromocytoma is a challenging case for any anesthesiologist and a team approach is required throughout the perioperative period to prevent anticipated difficulties and best manage any unforeseen complications that develop. We discuss successful management of certain unique challenges, like multifocal arrhythmias and surgical rebleed during tran...

Background and aim: Tracheoesophageal fistula (TEF) is a congenital disorder that presents as a surgical emergency in neonates. In regions where Neonatal Intensive Care Unit (NICU) facilities and resources are inadequate and skilled personnel are scarce, neonates, when not extubated on table, contributes to mortality. Our aim was to assess and comp...

Background and aims Regional anaesthesia has been advocated as a preferred modality during the coronavirus disease 2019 (COVID‑19) pandemic, but pursuing regional anaesthesia during COVID-19 is challenging. Our cross-sectional survey aimed to analyze the challenges in conducting regional anaesthesia and the alterations in practices imposed by the C...

Superior vena cava (SVC) syndrome, a potentially life threatening medical emergency, occurs due to SVC obstruction caused by extrinsic compression, intrinsic stenosis or thrombosis. Malignant mediastinal tumours account for more than 80% of cases of SVC syndrome. We hereby report a case of SVC syndrome who came with clinical features suggestive of...

The Coronavirus Disease 2019 (COVID-19) pandemic overwhelmed not just the resources in terms of infrastructure but also manpower. With many healthcare workers turning COVID-19 positive themselves, and the healthcare system being overburdened, we were short-staffed in most health Institutions across India. In anticipation of a similar crisis, at our...

Background: Arthroscopic rotator cuff repair surgery may lead to significant postoperative pain. Interscalene block (ISB) is an effective analgesic technique in these surgeries but there is a risk of the phrenic blockade. Subacromial local anesthetic infiltration is a phrenic sparing alternative technique for postoperative analgesia. The primary a...

BACKGROUND After Total abdominal hysterectomy (TAH) is a major surgery and is associated with significant morbidity, if pain is not adequately controlled intra- and postoperatively. Epidural analgesia with a variety of local anaesthetics and adjuvants is widely used for TAH as it provides both intra- and post-operative analgesia. Primary objective...

Erector spinae block is a relatively new block which gives comparable analgesia but lesser side effects as compared to other techniques like epidural block, paravertebral block, intercostal or interpleural block. We hereby present a case of a patient posted for nephrectomy, in whom epidural block was deferred due to previous spine surgery and neuro...

Situs inversus totalis, a rare condition presents with multitude of problems due to multiple structural and functional abnormalities that coexist with it like cardiac, spine and airway malformations. We are reporting a patient who had situs inversus totalis and was operated for upper limb fracture. The present case report emphasises on the challeng...

A 64-year-old gentleman presented to us for wound debridement of left foot with diabetic ulcer. The patient had 2 ulcers (5 X 3 cm and 3 X 2 cm) on the left foot since around 10 days. Earlier the ulcers were smaller in size for which he was getting dressing done from a local hospital.

p class="abstract">With increasing life expectancy, the mean age of patient orthopedicians and anesthesiologists have to deal with is increasing. In this review article, we discuss the case management of three centurions aged 110, 105 and 102 years respectively who underwent lower limb orthopedic surgery under nerve block, general anesthesia and ne...

Background: Melatonin has unique properties of anxiolysis, hypnosis, and analgesia without impairing psychomotor skills. We studied the dose requirements of thiopentone for induction of general anesthesia following administration of oral melatonin compared to that of placebo. Methods: The study is a prospective randomized double-blinded study condu...

Aim: To compare the characteristics of spinal blockade following intrathecal administration of isobaric 0.5% levobupivacaine (12.5mg) to 0.5% isobaric levobupivacaine (10 mg) with 25µg fentanyl and 0.5% hyperbaric bupivacaine (12.5mg) in patients undergoing elective sub umbilical surgery. Methodology: This is a prospective double blinded comparativ...