Implications of Subarchnoid Block in Senile Kyphosis.

Since the literature related to safety or efficacy of placing spinal blocks in patients with kyphosis is lacking, we aim to discuss about the anaesthesia implications of spinal anaesthesia in senile kyphosis. We successfully administered spinal anesthesia in three elderly patients with predominant kyphotic deformity with absent or mild scoliosis. The needle insertion attempts did not exceed two and a smaller dose of anesthetic was sufficient. While choosing spinal anaesthesia in patients with kyphosis, a risk benefit analysis needs to be performed based on the co-presence of scoliosis and its severity, desired level of anesthesia, and associated or coexisting systemic illness.

Conquering Phagophobia: A Journey to Overcoming the Fear of Choking.

Phagophobia is a rare and debilitating mental health condition characterized by an intense fear of choking solid food or liquids. Usually there is no underlying anatomical or physiological abnormalities. Choking phobia can lead to the avoidance of solid foods and liquids. This can give rise to other psychiatric disorders like major depressive disorder and anxiety disorder. Only few case reports of choking phobia are available in the literature. Here we present the case of a middle-aged man, with a 10-year history of fear of choking, starting after an aspiration episode and later maintained by a similar episode. The patient felt that food would be stuck in the windpipe, and he could not breathe while swallowing solid food and liquids. This eventually led to reduced eating and drinking causing significant weight loss. He also isolated himself and became depressed. After several searches for help in somatic healthcare, including surgery for deviated nasal septum, the patient was finally investigated in a psychiatric clinic and treated with pharmacological measures and behavioral therapy with considerable improvement within a few months. Choking phobia can mimic different physical conditions and is often misdiagnosed. Early recognition and timely referral to mental health professionals are vital for effective management.

Scleral Fixation of Intraocular Lens with Ab Interno Technique.

INTRODUCTION: Implantation of scleral fixation intraocular lens for the surgical management of aphakia cases without capsular support is a safe procedure. METHODS: Prospective study was carried out at Lumbini Eye Institute, Bhairahawa. A total of 32 patients underwent scleral fixation intraocular lens implantation within a period of two years from February 2014 to February 2016. RESULTS: The age range was from 15 to 79 years; mean age was 47.56 ± 20.16 SD. Among them 14 (43.75%) were male and 18 (56.25%) were female. The follow-up lasted for 24 months. CONCLUSIONS: SFIOL for the surgical management of aphakia in the absence of capsular support is a safe procedure. The long-term follow-up is needed for an accurate evaluation of outcomes.