Achondroplasia is a rare genetic disorder that affects endochondral ossification resulting in decreased linear bone growth. It is a form of primary skeletal dysplasia that accounts for more than 90% of disproportionate short stature in humans with an incidence of approximately 1 in 15,000–1 in 40,000 live births. These patients present with a characteristic craniofacial appearance along with musculoskeletal, respiratory, and cardiac abnormalities that, when superimposed with the physiological changes of pregnancy, may complicate anesthetic management. The paucity of evidence-based recommendations and protocols for the anesthetic management of parturients with achondroplasia for cesarean delivery poses a challenge in the choice of anesthesia and warrant special anesthetic considerations. Knowing the intricate relationship between the existing anatomical and physiological changes in achondroplasia and pregnancy is crucial for favorable patient outcomes. This is a case report of a 26-year-old primipara with achondroplasia who had a cesarean delivery for malpresentation under spinal anesthesia.

Human ; Female ; Adult: 25-44 Yrs Old ; Achondroplasia ; Cesarean Section ; Dwarfism ; Anesthesia, Spinal

The implementation of enhanced recovery after surgery (ERAS) protocols has led to increased interest in nonintubated video-assisted thoracoscopic surgery (NIVATS), especially in patients with compromised pulmonary function. We present a case of a 62-year-old female with stage IIIA breast cancer and pulmonary bronchiectasis who underwent right-sided wedge resection via NIVATS. A two-level thoracic paravertebral block (TPVB) at T4 and T6 using 0.4% isobaric bupivacaine with epinephrine was performed, resulting in sensory block from T2 to T7. An intrathoracic vagal block with 0.5% bupivacaine was administered to prevent cough. Sedation was maintained with dexmedetomidine and remifentanil. Surgery lasted 83 minutes with no complications. Postoperatively, pain was minimal (NRS 0–2), the patient mobilized within 6 hours and was discharged the next day. This case highlights the feasibility and safety of TPVB-based NIVATS in a high-risk patient, aligning with ERAS goals of enabling early recovery, avoiding airway instrumentation and minimizing opioid use.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Bronchiectasis ; Enhanced Recovery After Surgery ; Anesthesia, Conduction ; Anesthesia, Regional ; Thoracoscopy ; Thoracoscopic Surgery

Achondroplasia is a rare genetic disorder that affects endochondral ossification resulting in decreased linear bone growth. It is a form of primary skeletal dysplasia that accounts for more than 90% of disproportionate short stature in humans with an incidence of approximately 1 in 15,000–1 in 40,000 live births. These patients present with a characteristic craniofacial appearance along with musculoskeletal, respiratory, and cardiac abnormalities that, when superimposed with the physiological changes of pregnancy, may complicate anesthetic management. The paucity of evidence-based recommendations and protocols for the anesthetic management of parturients with achondroplasia for cesarean delivery poses a challenge in the choice of anesthesia and warrant special anesthetic considerations. Knowing the intricate relationship between the existing anatomical and physiological changes in achondroplasia and pregnancy is crucial for favorable patient outcomes. This is a case report of a 26-year-old primipara with achondroplasia who had a cesarean delivery for malpresentation under spinal anesthesia.

Human ; Female ; Adult: 25-44 Yrs Old ; Achondroplasia ; Cesarean Section ; Dwarfism ; Anesthesia, Spinal

The implementation of enhanced recovery after surgery (ERAS) protocols has led to increased interest in nonintubated video-assisted thoracoscopic surgery (NIVATS), especially in patients with compromised pulmonary function. We present a case of a 62-year-old female with stage IIIA breast cancer and pulmonary bronchiectasis who underwent right-sided wedge resection via NIVATS. A two-level thoracic paravertebral block (TPVB) at T4 and T6 using 0.4% isobaric bupivacaine with epinephrine was performed, resulting in sensory block from T2 to T7. An intrathoracic vagal block with 0.5% bupivacaine was administered to prevent cough. Sedation was maintained with dexmedetomidine and remifentanil. Surgery lasted 83 minutes with no complications. Postoperatively, pain was minimal (NRS 0–2), the patient mobilized within 6 hours and was discharged the next day. This case highlights the feasibility and safety of TPVB-based NIVATS in a high-risk patient, aligning with ERAS goals of enabling early recovery, avoiding airway instrumentation and minimizing opioid use.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Bronchiectasis ; Enhanced Recovery After Surgery ; Anesthesia, Conduction ; Anesthesia, Regional ; Thoracoscopy ; Thoracoscopic Surgery

Achondroplasia is a rare genetic disorder that affects endochondral ossification resulting in decreased linear bone growth. It is a form of primary skeletal dysplasia that accounts for more than 90% of disproportionate short stature in humans with an incidence of approximately 1 in 15,000–1 in 40,000 live births. These patients present with a characteristic craniofacial appearance along with musculoskeletal, respiratory, and cardiac abnormalities that, when superimposed with the physiological changes of pregnancy, may complicate anesthetic management. The paucity of evidence-based recommendations and protocols for the anesthetic management of parturients with achondroplasia for cesarean delivery poses a challenge in the choice of anesthesia and warrant special anesthetic considerations. Knowing the intricate relationship between the existing anatomical and physiological changes in achondroplasia and pregnancy is crucial for favorable patient outcomes. This is a case report of a 26-year-old primipara with achondroplasia who had a cesarean delivery for malpresentation under spinal anesthesia.

Human ; Female ; Adult: 25-44 Yrs Old ; Achondroplasia ; Cesarean Section ; Dwarfism ; Anesthesia, Spinal

The implementation of enhanced recovery after surgery (ERAS) protocols has led to increased interest in nonintubated video-assisted thoracoscopic surgery (NIVATS), especially in patients with compromised pulmonary function. We present a case of a 62-year-old female with stage IIIA breast cancer and pulmonary bronchiectasis who underwent right-sided wedge resection via NIVATS. A two-level thoracic paravertebral block (TPVB) at T4 and T6 using 0.4% isobaric bupivacaine with epinephrine was performed, resulting in sensory block from T2 to T7. An intrathoracic vagal block with 0.5% bupivacaine was administered to prevent cough. Sedation was maintained with dexmedetomidine and remifentanil. Surgery lasted 83 minutes with no complications. Postoperatively, pain was minimal (NRS 0–2), the patient mobilized within 6 hours and was discharged the next day. This case highlights the feasibility and safety of TPVB-based NIVATS in a high-risk patient, aligning with ERAS goals of enabling early recovery, avoiding airway instrumentation and minimizing opioid use.

Human ; Female ; Middle Aged: 45-64 Yrs Old ; Bronchiectasis ; Enhanced Recovery After Surgery ; Anesthesia, Conduction ; Anesthesia, Regional ; Thoracoscopy ; Thoracoscopic Surgery

INTRODUCTION: Despite establishing immunization as an effective approach, the number of deaths from immunizable diseases among 0 to 14 years old remained high in 2012. This prompted the researchers to determine the knowledge, attitude and practices of mothers/caregivers regarding the immunization of their children. METHODS: The research utilized a descriptive cross-sectional design. An interviewer-guided validated questionnaire was administered to mothers and caregivers with at least one child 12 months or younger who was eligible for immunization. RESULTS: Around half of the 211 respondents were aged 20-35 years old, married and living in their own home. A large percentage were unemployed, and the highest educational attainment was high school. Most respondents had one child in care undergoing immunization, mostly in a health center. Results showed that all respondents scored below the MPL for knowledge. For attitude, all scored above the MPL. Only 45.02% of mothers/caregivers scored above the MPL for practices. CONCLUSION Despite poor knowledge, mothers and caregivers displayed good attitude towards immunization, however this did not translate into bringing their children for vaccination.
Immunization