Kolkata, India


Kolkata, India
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Sinha S.,IPGMEandR | Mukherjee M.,RGKMCandH | Chatterjee S.,NRSMCandH | Vijay M.,IPGMEandR | Hazra A.,IPGMEandR
Anaesthesia, Pain and Intensive Care | Year: 2012

Aim: To compare the efficacy of paravertebral block with ropivacaine or ropivacaine plus dexmedetomidine for relief of post operative pain in patients undergoing unilateral renal surgeries. Methodology: Sixty adult patients of ASA I & II, undergoing unilateral renal surgery, were included in this prospective, randomized study. After placing the catheter in T12-L1 paravertebral space, block was randomly activated either by 18 ml of ropivacaine 0.25% (Group I) or by 18 ml of ropivacaine 0.25% plus 1μg/kg dexmedetomedine (Group II). General anaesthesia was instituted in all patients using a standardised technique. After recovery from GA, pain was assessed by VAS. The patients were administered ! rst top up dose through paravertebral route as soon as VAS score exceeded 3 and time was noted duration of analgesia. Total requirement of ropivacaine in 24 hours was also noted. Result: Mean duration of analgesia was longer in Group II (324.4 ± 56.35 min) as compared to Group I (149.2 ± 30.64 min) (p < 0.05). Mean total consumption of ropivacaine was 84 ± 14.12 mg in Group II and 120 ± 15.26 mg in Group I (p < 0.05). Conclusion: Addition of dexmedetomidine to local anaesthetic agent ropivacaine signi! cantly prolongs the duration of analgesia in paravertebral blocks.

Banerjee D.,IPGMEandR | Hassarajani S.A.,Bhabha Atomic Research Center | Maity B.,IPGMEandR | Narayan G.,Bhabha Atomic Research Center | And 2 more authors.
Food and Function | Year: 2010

The healing activity of black tea (BT) and BT fermented with Candida parapsilosis and kombucha culture, designated as CT and KT respectively against the indomethacin-induced stomach ulceration has been studied in a mouse model. The KT sample (KT4) produced by fermenting BT for four days, showed the best DPPH radical scavenging capacity and phenolics contents. Hence the ulcer-healing activity of KT4 was compared with those of CT4 and BT. All the tea extracts (15 mg kg-1) could effectively heal the gastric ulceration as revealed from the histopathological and biochemical studies, with relative efficacy as KT4 > CT4 ∼ BT. The healing capacities of the tea extracts could be attributed to their antioxidant activity as well as the ability to protect the mucin content of the gastric tissues. In addition, the ability of KT4 to reduce gastric acid secretion might also contribute to its ulcer-healing activity. The tea preparation KT4 (15 mg kg-1) was as effective as the positive control, omeprazole (3 mg kg-1) in ulcer healing. © The Royal Society of Chemistry.

Maitra S.,IPGMEandR | Sen S.,IPGMEandR | Pal S.,MGM Medical College
Egyptian Journal of Anaesthesia | Year: 2013

Perioperative management of peripartum cardiomyopathy patients posted for emergency caesarean section is a unique challenge to the anaesthesiologist. We are hereby reporting a case of peripartum cardiomyopathy posted for emergency caesarean section. A 23 year old lady with a 35 weeks pregnancy was admitted in our hospital with increasing breathlessness. Subsequently, she was diagnosed as a case of peripartum cardiomyopathy. She was posted for an urgent LUCS. After a rapid initial stabilization, she received combined spinal fentanyl with titrated epidural bupivacaine to achieve surgical anaesthesia. Apart from routine ASA monitors, CVP and IBP were monitored during the surgery. Hemodynamic perturbations were insignificant during surgery, and the postoperative period was uneventful. Key Messages: Combined spinal opioid with carefully titrated epidural anaesthesia is a safe and effective technique for anaesthetic management of peripartum cardiomyopathy posted for LUCS. © 2013 Production and hosting by Elsevier B.V. on behalf of Egyptian Society of Anesthesiologists.

Ghosh A.,RG Kar Medical College and Hospital | Ghosh B.,IPGMEandR | Pain S.,RG Kar Medical College and Hospital | Pande A.,RG Kar Medical College and Hospital | And 3 more authors.
Indian Journal of Rheumatology | Year: 2011

To investigate the relationship among DAS28, CDAI and HAQ-DI in early rheumatoid arthritis (RA) patients. It was a prospective study on 61 consecutive DMARD naive early RA patients attending the outpatient department of a tertiary care hospital in eastern India. DAS28, CDAI and HAQ-DI were calculated at the initial visit. They were put on DMARD therapy as per protocol with categorization of disease activity as per the CDAI values. DAS28, CDAI and HAQ-DI were again calculated after 3 months. Statistical analysis was carried out. There was a significant correlation among HAQ-DI, DAS28 and CDAI values. HAQ-DI showed significant correlation with the individual variables used in CDAI and DAS28. These observations were noted both in the initial and after 3-month follow-up values. There was significant agreement between the disease activity categories obtained by CDAI and DAS28 cut-off levels. Combination DMARD therapy based on ACR 2008 recommendations resulted in significant improvement in disease activity and functional disability. We can assess the disease activity in the patients by recording the HAQ-DI, at least in cases of early RA. Both DAS28 and CDAI are equally useful in assessing the disease activity of RA. These facts become important as it suggests that laboratory values do not remain absolutely essential in the assessment of the patients. These findings are especially important in a fund-stricken health system in developing countries like India. © 2011 Indian Rheumatology Association.

Sarkar S.,IPGMEandR | Mondal R.,North Bengal Medical College and Hospital | Nandi M.,IPGMEandR | Das A.K.,Maldah Medical College and Hospital
Indian Journal of Pediatrics | Year: 2013

Tacrolimus, a reversible calcineurin inhibitor, is known for its diabetogenic potential. The incidence of diabetes is less frequent among the patients of nephrotic syndrome in comparison to organ transplant recipients. Diabetic ketoacidosis (DKA) is even rarer. DKA as the first presentation of new onset tacrolimus induced transient type 1 diabetes despite a lower dose range and low trough level of the drug is being reported in a 12-y-old girl with steroid resistant nephrotic syndrome. © 2012 Dr. K C Chaudhuri Foundation.

Bain J.,I.P.G.M.E.and.R. | Lal S.,E.M.A.R.C. | Baghel V.,Ss Medical College | Yedalwar V.,Ss Medical College | And 2 more authors.
Journal of Natural Science, Biology and Medicine | Year: 2014

Introduction: Burn injuries are a serious public health problem. In our study we have identified different epidemiological factors based on 10 years of our experience at a burn unit in central India and recommend some strategies to prevent burn injuries. Materials and Methods: This is a retrospective analysis (2001-2010) of database from burn unit of S.S. Medical College, Rewa, India. Results: 2499 patients with burn injury were analysed. 66.8% and 38.2% patients were females and males respectively, with a median age of 25 years. Flame (80.1%) was most common cause, home (96%) was most common place, traditional Indian stove (28.8%), kerosene lamp (26.7%), hot liquid (12.2%) and kerosene stove (10.4%) were common causes. Median Total Body Surface Area (TBSA) burn was 40.0%; females had significantly greater (P < 0.001) burn than males (median 50% vs 26.0%). High mortality (40.3%) seen; female sex (OR 3.22, 95% CI 2.65-3.92); young age (15-29 year) (OR 3.48, 95% CI 2.45-4.94); flame burn (OR 12.9, 95% CI 1.69-98.32); suicidal burn OR 6.82 95%CI 4.44-10.48) and TBSA > 76% (OR 3099, 95%CI 1302-7380) were significant risk factors for death. Median hospital stays was 8 days; shorter hospital stays seen among TBSA burn > 76% (2 days), suicidal intent (4 days), and those who expired (4 days). Septicemia (45.8%) and burn shock (41%) were the major cause for death. Conclusions: Cooking and lighting equipments are major cause of burn injury among females and young age group. Equipment modification to improve safety features and public awareness programs are necessary to reduce burn incidents.

Sarkar D.K.,I.P.G.M.EandR | Maji A.,Nrs Medical College | Saha S.,I.P.G.M.EandR | Biswas J.K.,I.P.G.M.EandR
Indian Journal of Surgical Oncology | Year: 2011

Oncoplastic breast surgery is the fusion of oncological and surgical principles to gain successful breast tumour excision with good cosmesis. It is an widely accepted and popular method in the western world. However, the picture is different in India. The major issues here, like late detection and advanced tumours, poor socio-economic status overriding quality of life issue and shortage of dedicated oncoplastic surgeons result in a poor acceptance and practice of oncoplastic breast surgery. This article explores the use of various oncoplastic techniques in clinical practice and discusses future directions in this emerging field in an Indian perspective. In our institute (breast care unit, I. P. G. M. E&R,Kolkata), we performed a retrospective study over a period of five years (2005-2009). It included a sample size of 30 patients with diagnosed breast cancer or Phylloides Tumor (PT). The study focused on the indications, type of oncoplastic procedure used, cosmetic outcome (shape / volume replacement, ptosis correction & chest wall coverage), complications faced and response to subsequent therapy. The indications, for which oncoplastic techniques were applied, were DCIS (2), LCIS (1), IDC (19) and phylloides tumor (8). Of the 30 patients, RAT was used in 8, LDMF (of various types and volume) was used in 16, pedicled TRAM flap was used in 3 and reduction mastopexy in 3. The procedural indications of reconstruction were total glandular replacement by TRAM flap, mini-LDMF to fill volume loss after BCS or wide local excision, rotation advancement technique for reshaping / symmetry maintenance after BCS or wide local excision, LDMF for chest wall coverage after MRM and reduction mastopexy after wide local excision. From patient's point of view the outcome of surgery was highly satisfactory (score 3 or more) in 19 out of 30 patients (63. 33%). LDMF was the most commonly used (16 out of 30) oncoplastic procedure with least complication rates (0 out of 16). 4 out of 30 patients had complications related to the procedure. Chest wall coverage after MRM still forms the main indication of oncoplastic surgery in this country. © 2011 Indian Association of Surgical Oncology.

Mukhopadhyay B.,R G Kar Medical College | Khan Md.S.,R G Kar Medical College | Uz Zaman Md.S.,IPGMEandR
Biomedicine (India) | Year: 2013

Introduction: Prevalence of Diabetes Mellitus (DM) is increasing gradually particularly in India. DM leads to secondary pathophysiological changes including those of respiratory system. Biochemical changes result in impaired collagen and elastin cross-linkages leading to reduced strength and elasticity of connective tissues. In the lungs it leads to thickened alveolar and capillary lamina leading to reduced pulmonary elastic recoil and lung volumes affecting ventilation. Aim: Current study was done to evaluate various lung function tests subclinical pulmonary dysfunction in cases of DM at an early stage for prompt intervention to reduce morbidity and mortality. Materials and Methods: Sixty diabetic patients and sixty non-diabetic subjects were selected as cases and controls and studied at RG Kar Medical College for FVC-PP, FEV1-PP, FEV1/FVC-PP, PEFR-PP, DLCO, DL/VA, FEF-PP. Results: All except FEV1/FVC-PP showed significant reduction in patients with DM.

Pandey P.K.,IPGMEandR | Shukla S.,IPGMEandR | Bera M.K.,IPGMEandR | Kundu A.K.,IPGMEandR | Das S.,IPGMEandR
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2011

Candida species can cause a wide variety of clinical syndromes, especially in immunocompromised and diabetic patients. Primary perirenal candidial abscess has been a rare reported entity. Here we report a rare case of primary PNA due to Candida species in an immunocompetent patient with diabetes mellitus and its minimal invasive management. Retrospective and prospective analysis of clinical, laboratory and radiological records along with continued follow up of patient was done. This patient was 48-year-old man, admitted with burning in micturition, right flank discomfort and low grade fever since 1 year. Abdominal ultrasound and computerized tomography were suggestive of a PNA of the right kidney. Candida species was isolated from sample obtained by C.T. guided needle aspiration. Culture of aspirate showed sensitivity to azoles. Systemic antifungal therapy based on culture report was started in form of oral drug. The patient responded well leading to resolution of lump and the fever. Appropriate timely treatment appears to be having a promising role in definitive therapy for renal and PNA due to Candida even in immunocompetent host with predisposing factors such as diabetes mellitus. This case highlights the fact that fungal infections should be included in the differential diagnosis of PNA in such patients.

Dasgupta S.,IPGMEANDR | Mukherjee S.,IPGMEANDR | Das R.N.,IPGMEANDR | Chatterjee U.,IPGMEANDR | Chtterjee M.,IPGMEANDR
Annals of Tropical Medicine and Public Health | Year: 2014

Post kala-azar dermal leishmaniasis, generally develops 6 months 10 years after apparent successful cure from visceral leishmaniasis. Rarely, it shows the feature of perineurial infiltration. This causes diagnostic confusion with tuberculoid leprosy, especially in countries like India, where leprosy is endemic.

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