Airway Management in a Toddler with a Giant Hemangioma of the Tongue

Background: Induction of general anesthesia in a patient with compromised airway has always caused dilemma to anesthesiologist, especially for toddler this is paramounted. Case Presentation: An 18 month old boy had a huge sized lingual mass which not only filled entire oral cavity but protruded outside the mouth up to about 5 cm. Having in mind the diagnosis of hemangioma, prior to induction it was attempted to reduce the mass but could be reduced only minimally by manual decompression. While the tongue, still outside the mouth, with full preparedness for anesthesia was induced maintaining the spontaneous ventilation. During laryngoscopy and intubation the tongue was pulled out of the oral cavity to ease the passage of the endotracheal tube. The mass was excised successfully and patient had an uneventful postoperative course. Conclusion: Maintenance of spontaneous ventilation is the crucial safety element during induction

A Giant Hemangioma of the Tongue

Introduction: Vascular abnormalities are relatively uncommon lesions, but head and neck is a common region for vascular malformation which is classified as benign tumors. In this paper, the authors report a rare presentation of vascular malformation in the tongue and its managements. Case Report: An 18 months 2 old child presented with a giant mass of tongue which caused functional and aesthetic problem. The rapid growth pattern of cavernous hemangioma was refractory to corticosteroid. The lesion was excised without any complication. Since the mass was so huge that not only filled entire oral cavity but was protruding outside, airway management was a great challenge for anesthesia plan and at the same time surgical technique was difficult to select. Conclusion: Despite different recommended modalities in managing hemangiomas of the tongue, in cases of huge malformations, surgery could be the mainstay treatment and provided that critical care measures are taken in to account, could be performed very safely

Protective role of lipoic acid on methotrexate induced intestinal damage in rabbit model

Abstract Methotrexate (MTX), a folate antagonist agent, is mainly used in treatment of malignant tumors and auto immune diseases and affects not only tumor cells, but also gastrointestinal mucosa. The present study was undertaken to determine whether lipoic acid (LA) could ameliorate methotrexate-induced oxidative intestine injury in rabbits. Twenty-one rabbits were randomly assigned into three groups: Group 1 (control group), Group 2 (received 20 mg/kg MTX), Group 3 (received MTX plus LA 75 mg/kg orally). On the 6th day rabbits were anesthetized and intestinal tissue sampled for pathologic and biochemical assessment. The intestinal tissue injury index and malondialdehyde (MDA) levels were lower in MTX+LA group as compared to the MTX group, and tissue glutathione peroxidase (GPx) and superoxide dismutase (SOD) activity were higher in MTX+LA group than in the MTX group (p<0.05). These findings suggest that coadministration of LA with MTX is associated with reduction in oxidative injury and tissue damage in the intestine. We suggest that lipoic acid may have a protective role in the MTX-induced oxidative injury

Protective role of lipoic acid on methotrexate induced intestinal damage in rabbit model

Abstract Methotrexate (MTX), a folate antagonist agent, is mainly used in treatment of malignant tumors and auto immune diseases and affects not only tumor cells, but also gastrointestinal mucosa. The present study was undertaken to determine whether lipoic acid (LA) could ameliorate methotrexate-induced oxidative intestine injury in rabbits. Twenty-one rabbits were randomly assigned into three groups: Group 1 (control group), Group 2 (received 20 mg/kg MTX), Group 3 (received MTX plus LA 75 mg/kg orally). On the 6th day rabbits were anesthetized and intestinal tissue sampled for pathologic and biochemical assessment. The intestinal tissue injury index and malondialdehyde (MDA) levels were lower in MTX+LA group as compared to the MTX group, and tissue glutathione peroxidase (GPx) and superoxide dismutase (SOD) activity were higher in MTX+LA group than in the MTX group (p<0.05). These findings suggest that coadministration of LA with MTX is associated with reduction in oxidative injury and tissue damage in the intestine. We suggest that lipoic acid may have a protective role in the MTX-induced oxidative injury