Background:The Truview™ EVO2 laryngoscope, with its unique optical lens system and blade tip angulation, has proved its usefulness in providing adequate laryngeal exposure and intubation via the oral route. However, the same has not been evaluated for nasotracheal intubation.Aim:We evaluated the suitability of the Truview™ EVO2 laryngoscope for nasotracheal intubation.Methods:Fifty ASA grade I and II elective surgical patients were studied. Patients aged below 15 years or having difficult airway were excluded. Under standard anesthesia protocol, nasotracheal intubation was performed using a Truview™ EVO2 laryngoscope and, in cases of inability to complete intubation in three attempts, the Macintosh laryngoscope was used. Time taken for intubation, use of Magill's forceps and need for optimization maneuvers were noted. The primary outcome was percentage of successful intubation, while hemodynamic changes and duration of intubation were taken as secondary outcomes.Results:Majority (94%) could be intubated successfully with the Truview™ EVO2 laryngoscope. Average time taken for intubation was 50.1 s. The hemodynamic changes were not clinically significant. Regression analysis revealed lack of association between duration of intubation and hemodynamic changes. There were no serious complications.Conclusion:The Truview™ EVO2 laryngoscope is a useful tool in performing nasotracheal intubation, ensuring a high level of success rate among patients with normal airway anatomy.

A 76-year-old kyphoscoliotic female patient presented with severe pain and sudden acute abdominal distension for 1-week and was diagnosed to have right-sided massive twisted ovarian cyst. The patient was a known case of hypertension, dilated cardiomyopathy with low 20% cardiac ejection fraction. Though very few incidences of multiple co-morbid conditions existing together in a single elderly patient have been reported in the past, it is important to titrate the dosage, type of anesthetic agents and their routes of administration in high risk patients.

Cardiac myxomas are the commonest benign tumour of the heart. We are describing a rare presentation of a myxoma in a patient with renal cell carcinoma (RCC). Since there was no single reported case of myxoma with RCC, a presumptive diagnosis of RCC with right atrial extension of tumour thrombus was made. Both the tumours were resected in the same operation by radical nephrectomy with open heart surgery.

Cardiopulmonary resuscitation (CPR) is a life-saving skill involving chest compressions & ventilation to pump oxygenated blood through the vital organs of the body. Among different techniques and devices for chest compression, no single method has been definitively shown to produce the best outcome and hence, direct comparisons between them are not possible. Internal cardiac massage is the manual squeezing of the heart through a surgical incision into the chest cavity, when the chest is already open for cardiac surgery. Unlike the usual cardiac arrest scenarios, internal cardiac massage is employed mostly in cardiothoracic surgical patients and will have more chance for survival and favorable neurologic outcomes across all durations of CPR. We describe two cases of return of spontaneous circulation (ROSC) after prolonged CPR with internal cardiac massage performed in hospital setting.