RSC and LSC are feasible procedures with acceptable complication rates. RSC enables operating more anatomically with less bleeding.

Introduction and importance Several complications after corona viral infection-19 (COVID-19) have been reported. The study aims is to present a case with post-covid-19 pulmonary fungal infection with antifungal resistance characteristics. Case presentation A 50-year-old male presented with hemoptysis, dyspnea, cough, fever, and rigor for 4-month duration. Three weeks before this complaint, he had cured of COVID-19. Investigations showed multiple ill-defined cavitary lesions involving the left upper lobe. The patient underwent a left upper lobectomy. The post-operative period was uneventful. Clinical discussion All studies of COVID-19 fungal infections reported occurrence during the COVID-19 infection, mostly 14 days after the appearance of COVID-19 symptoms. The case in the current study was a 50-year-old patient, who was previously diagnosed with COVID-19 for a period of 4 months. After a few days from his recovery, the patient developed dyspnea, cough, fever, and rigor again. Conclusion Pulmonary aspergillosis is a serious complication of COVID-19 patients that may not respond well to medical therapy. Pulmonary resection is the last and effective strategy to control the disease.

Understanding the pharmacokinetics parameter of colistin methanesulfonate sodium (CMS) and colistin is needed to optimize the dosage regimen in critically ill patients. However, there is a scarcity of pharmacokinetics parameters in this population. This review provides a comprehensive understanding of CMS and colistin pharmacokinetics parameters in this population. The relevant studies published in English that reported on the pharmacokinetics of CMS and colistin from 2000 until 2020 were systematically searched using the PubMed and Scopus electronic databases. Reference lists of articles were reviewed to identify additional studies. A total of 252 citation titles were identified, of which 101 potentially relevant abstracts were screened, and 25 full-text articles were selected for detailed analysis. Of those, 15 studies were included for the review. This review has demonstrated vast inter-study discrepancies in colistin plasma concentration and the pharmacokinetics parameter estimates. The discrepancies might be due to complex pathophysiological changes in the population studied, differences in CMS brand used, methodology, and study protocol. Application of loading dose of CMS and an additional dose of CMS after dialysis session was recommended by some studies. In view of inter-patient and intra-patient variability in colistin plasma concentration and pharmacokinetics parameters, personalized colistin dosing for this population is recommended.

Reported levels of pain and analgesic use during the first 24 h following robotic gynecologic surgery were significantly lower following general and spinal anesthesia compared to general anesthesia alone.

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