Natl Med J India
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. Surgical healthcare across low- and middle-income countries is plagued with concerns over scarcity of anaesthesiologists. Orthopaedic surgeons working in such resource-limited settings are often caught in a dilemma to provide emergency orthopaedic surgical care without an attending anaesthesiologist. Therefore, an effective, low-risk solution is necessary to ensure safe emergency orthopaedic care. ⋯ . Axillary regional block is an efficacious, low-risk anaesthesia for emergency orthopaedic procedures of the hand, forearm and elbow, in resource-limited settings where an anaesthesiologist is not available.
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Malignant melanoma is an aggressive malignancy with high recurrence rates after curative surgery and in advanced stages is characterized by resistance to conventional chemotherapy. With better understanding of the genomic landscape and mutational signature of these tumours over the past decade, there has been a paradigm shift in management of melanoma using immunotherapy (anti-PD-1 and anti-CTLA-4 antibodies) and targeted drugs against BRAF and MEK. ⋯ However, these drugs have varying toxicity profiles and there are no studies comparing these two classes of drugs in either the adjuvant or metastatic setting leaving the question of sequencing open to clinical judgement. Moreover, availability and cost are issues that need to be considered before use of these drugs in the Indian setting.