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Precaution and careful evaluation of RD in the early postoperative period is recommended.The impact of air ventilation systems on airborne virus transmission (AVT), and aerosols in general, in confined spaces is not yet understood. The recent pandemic has made it crucial to understand the limitations of ventilation systems regarding AVT. We consider an elevator as a prototypical example of a confined space and show how ventilation designs alone, regardless of cooling or heating, contribute to AVT. Air circulation effects are investigated through multiphase computational fluid dynamics, and the performance of an air purifier in an elevator for reducing AVT is assessed. We have investigated three different flow scenarios regarding the position and operation of inlets and outlets in the elevator and a fourth scenario that includes the operation of the air purifier. The position of the inlets and outlets significantly influences the flow circulation and droplet dispersion. An air purifier does not eliminate airborne transmission. The droplet dispersion is reduced when a pair of an inlet and an outlet is implemented. The overall practical conclusion is that the placement and design of the air purifier and ventilation systems significantly affect the droplet dispersion and AVT. Thus, engineering designs of such systems must take into account the flow dynamics in the confined space the systems will be installed.The autoimmune rheumatic diseases (ARDs) are characterised by a pathological triad composed of autoimmunity/inflammation, microangiopathy and aberrant tissue remodelling. Disease terms such as idiopathic inflammatory myopathy (IIM), scleroderma/systemic sclerosis (SSc), and systemic lupus erythematosus (SLE) are helpful clinically but disguise the considerable overlap that exists within these 'distinct' disorders. This is perhaps best demonstrated by inflammatory myopathy, which can be present in SSc or SLE, but can itself be absent in clinically amyopathic IIM. Archetypal clinical manifestations of ARD (such as Raynaud's phenomenon) are frequently present, albeit with varying prominence, within each of these diseases. This is certainly the case for inflammatory myositis, which has long been recognised as an important clinical feature of both SSc and SLE. Progress in elucidating the clinicoserological spectrum of autoimmune rheumatic diseases has identified autoantibody specificities that are strongly associated with 'overlap' disease and the presence of inflammatory myositis in SSc and SLE. In this review, we shall describe the prevalence, burden, prognostic value and management considerations of IIM in the context of both SSc and SLE. A major emphasis on the value of autoantibodies shall highlight the value of these tools in predicting the future occurrence of inflammatory myositis in both SSc and SLE. Where applicable, unmet research needs shall be highlighted. The review emphasises the importance of myopathy as a common feature across all the ARDs, and highlights specific antibody specificities that are strongly associated with myopathy in the context of SLE and SSc.How to cite this article Mahajan C, Singh BP, Kapoor I, Prabhakar H. [https://www.selleckchem.com/products/ldc7559.html LDC7559] Phenytoin Sodium and Acetate-Maleate Buffered Balanced Salt Solutions are Physically Incompatible! Indian J Crit Care Med 2021;25(3)352.How to cite this article Cittadini A, Marsigli F, Sica A, Santonastaso DP, Russo E, Gamberini E, et al. Video Laryngoscopy-guided Nasal Intubation One More Bullet in Our Rifle. Indian J Crit Care Med 2021;25(3)351.How to cite this article Anand RK, Baidya DK, Maitra S, Ray BR. A Proposal for Dedicated "Prone Team" and "Prone Bundle of Care" in COVID-19 ICU. Indian J Crit Care Med 2021;25(3)349-350.Boerhaave's syndrome is a rare condition defined as the spontaneous rupture of the esophagus that generally occurs due to retching, forceful vomiting and sometimes even spontaneously. Atypical presentation often misleads the diagnosis leading to a delay in early intervention, and a strong clinical suspicion is indeed required to diagnose the condition. Definitive treatment being surgical repair, endoscopic intervention can be attempted in nonseptic patients. How to cite this article Kaladhar S, Nikilesh Kumar G, Misra KC, Hemanth C, Appasani S. Bee Sting to Boerhaave's Syndrome. Indian J Crit Care Med 2021;25(3)346-348.Re-expansion pulmonary edema (RPE) is a rare complication that may occur after treatment of lung collapse caused by pneumothorax, atelectasis, or pleural effusion. The amount of fluid drained and the degree of pleural suction influence the development of RPE. We present a case of RPE in a critically ill patient of scrub typhus with rheumatic heart disease, after draining only 800 mL of pleural fluid, thereby proving that the complex cardiac and pulmonary interactions play an important role in the development of RPE. How to cite this article Khanoria R, Chauhan R, Sarna R, Bloria S. Re-expansion Pulmonary Edema-A Rare Entity A Thin Line between Pulmonary and Cardiac Decompensation. Indian J Crit Care Med 2021;25(3)343-345.It is extremely rare for a cardiac tumor to present with coronary-cameral fistulas. A 66-year-old Caucasian male presented with worsening dyspnea and subsequently had a cardiac catheterization for an ST-elevation myocardial infarction, revealing no evidence of coronary artery disease but multiple coronary-cameral fistulas. Venoarterial (VA) extracorporeal membrane oxygenation was initiated for a severe cardiogenic shock. Workups including a transesophageal echocardiography and a right heart catheterization led to a diagnosis of metastatic melanoma involving both ventricles of his heart. Angiogenesis is well described in melanomas and our novel case reports the extremely rare association of coronary-cameral fistulas with a metastatic cardiac melanoma. How to cite this article Thyagarajan B, Bryant C, Khanna AK. An Incidental Finding of Coronary-cameral Fistulas in a Critically Ill Patient with a Metastatic Cardiac Tumor. Indian J Crit Care Med 2021;25(3)340-342.Hypotension can be explained by the cardiotoxic effects of an organophosphate poison, but a distributive shock is a rare event. This is a case report of a young north Indian man who presented to the emergency room in a comatose state and distributive shock. He was initially managed with intravenous crystalloids but required inotropic therapy to maintain the desired mean arterial pressure and organ perfusion and also required mechanical ventilation. He improved during the hospital stay only after 4 days when cocktail treatment of atropine was started considering the possibility of organophosphorus toxin exposure and had tapered off the inotropes and mechanical ventilation. Dichlorvos ingestion was confirmed later on after recovery from the coma. At 4-week follow-up, he developed delayed neuropathy. This case is a torchlight toward organophosphorus poisoning presenting as a distributive shock. Atropine may be used as a cocktail treatment in distributive shock where the diagnosis is uncertain. How to cite this article Suresh S, Panda PK.