Shillong, India


Shillong, India
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Kakati S.,Assam Medical College | Barman B.,NEIGRIHMS | Ahmed S.U.,Assam Medical College | Hussain M.,NEIGRIHMS
Journal of Clinical and Diagnostic Research | Year: 2017

Introduction: Neurological manifestations although common in Systemic Lupus Erythematosus (SLE), are often not recognized due to their diversed and varied presentation. Therefore, the study was planned to highlight the pattern of neurological involvement in SLE to help in early recognition. Aim: To study the pattern of neurological involvement in SLE and its correlation with disease activity and different investigation. Materials and Methods: This hospital based prospective observational study was carried out from August 2009 to July 2010. Diagnosed cases of SLE [based upon American Rheumatism Association (ARA) criteria] who presented with neurological manifestations at the time of diagnosis or develop during the course of the disease were included in the study. They were assessed clinically and investigated with neuroimaging and neurophysiological tests as applicable. Results: In total, 52 consecutive patients with SLE were evaluated, 92% were female. The most common age group was 21 to 25 years. Nervous system involvement was found in 19 (36.54%) patients. Cognitive impairment was the most frequent manifestation, present in 11 (57.89%) patients followed by seizure disorder in eight patients (42.1%). Peripheral neuropathy was diagnosed in eight (42.1%), acute confusional state in six (31.57%) and headache and depression was diagnosed in five (26.31%) patients each. Less common manifestations were psychosis, movement disorder and aseptic meningitis. Percentage of neurological manifestations directly correlated with disease activity. A significant difference was found in Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score between the patients with Neuro Psychiatric Systemic Lupus Erythematosus (NPSLE) and those without NPSLE (32.42±16.34 Vs 17.3±10.6). Conclusion: Neurological involvement in SLE is seen relatively early in the course of the disease with cognitive impairment being the most common manifestation and correlate with disease activity. © 2017, Journal of Clinical and Diagnostic Research. All Rights Reserved.

Mundhra R.,Guru Teg Bahadur Hospital | Agarwal M.,NEIGRIHMS
Journal of Clinical and Diagnostic Research | Year: 2013

Objective: To evaluate the foetal outcome in Meconium Stained Amniotic Fluid (MSAF). Material and Methods: This prospective observational study was carried out in the Department of Obstetrics and Gynaecology, North Eastern Indira Gandhi Regional Institute of Health And Medical Sciences, Shillong, India, over a period of eighteen months, from January 2010 to June 2011. A total of 355 pregnant women who had completed more than 37 weeks of gestation, with singleton pregnancies and cephalic presentations were included in this study. 165 cases with MSAF, were thus selected and they were compared with 190 randomly selected controls. Results: Among 165 cases, 27.88% of the cases had regular visits to the Institute at least 3 times previously, 72.12% cases had no previous visit at all. Primigravidas accounted for a majority of cases and approximately 50% cases had gestational ages of more than 40 weeks Pregnancies complicated with pregnancy induced hypertension had statistically significant higher rates of meconium staining among cases (16.97%), as compared to those among controls (7.89%). 21.81% cases had foetal heart rate abnormalities, as were detected by electronic foetal monitoring and presence of foetal bradycardia was statistically higher in cases compared to that in controls. Casearean section rates were nearly double in cases (49.09%). Neonatal outcome was poor in terms of low Apgar score at birth, birth asphyxia, Meconium Aspiration Syndrome (MAS) and increased neonatal admission among cases as compared to that among controls. Conclusion: Meconium stained amniotic fluid is really worrisome from both, obstetrician's and paediatrician's points of view, as it increases the caesarean rates, causes birth asphyxia, MAS and increases neonatal intensive care unit admissions.

PubMed | Columbia Asia hospital and NEIGRIHMS
Type: Journal Article | Journal: JNMA; journal of the Nepal Medical Association | Year: 2016

Guillain-Barre syndrome complicating pregnancy is a rare event which carries a high maternal risk. We presented a case of 23 years old pregnant lady diagnosed with GBS in third trimester who deteriorated after termination of delivery of the new born. Despite the availability of intravenous immunoglobulin and plasmapheresis and complications like ventilator associated pneumonia, tracheostomy, autonomic instability, patient was successfully managed due to a meticulous multidisciplinary involvement in our intensive care unit.

Medico-Legal Update | Year: 2014

Background: Every incident of poisoning is fraught with medico-legal and ethical implications. Knowledge of the poisoning profile in a particular area is helpful to ensure better management and prevention of such episodes in future. Method: All cases admitted to the emergency department of the hospital between July 2009 and June 2012 with suspicion of acute poisoning (from the history and clinical findings) were included in the study. Data was obtained retrospectively from the Casualty Medico-Legal Case (MLC) Registers for that period and analyzed using Microsoft Excel 2007. Results: Males in the age group 21 to 30 years were most commonly affected. The mode of poisoning was mainly an overdose of drugs and medicinal substances. The majority of cases were suicidal attempts. Conclusion: A multidisciplinary approach is needed to deal with the problem of suicidal poisoning, especially in the vulnerable age group of young adults and adolescents in the northeast region. The misuse of prescription drugs calls for health education and enforcement of laws to curb illicit sale and trafficking of medicinal substances.

Medico-Legal Update | Year: 2016

Hanging is a common method of suicide in India. During autopsy of hanging cases, hyoid becomes one of the integral parts of examination. Many previous research studies in the forensic literature have reported considerable difference in frequency of hyoid fracture in hanging cases. Beside this, there is also lack of unanimity of opinion regarding the relation of different variables of hanging with the hyoid fracture except age of the deceased. The present study is a retrospective analysis of all cases of death due to hanging brought to the department of Forensic Medicine, Assam Medical College & Hospital for medicolegal autopsy from 1st June, 2012 to 31st May, 2013, The purpose of the study is to evaluate the incidence and pattern of hyoid fracture in the study group and relation of 6 different variables of hanging with the hyoid fracture viz. age, sex, nature of ligature material, level of ligature mark, position of knot and manner of suspension of body. © 2016, World Informations Syndicate. All rights reserved.

Indian Journal of Surgery | Year: 2012

Post- traumatic diaphragmatic hernia is not an uncommon sequel. But lack of awareness of this condition may delay in diagnosis and result in life-threatening complications. CT scan is regarded as the investigative tool of choice but some prefer Barium studies in delayed cases of diaphragmatic hernia. Chest X- ray and Ultrasonography of the chest and abdomen may also help in arriving at a diagnosis. An awareness of the condition assisted by the radiological investigations will lead to an early diagnosis and treatment which ultimately helps in managing the patients with diaphragmatic hernias better. © 2012 Association of Surgeons of India.

Pradhan D.,NEIGRIHMS | Bhattacharyya P.,NEIGRIHMS
Indian Journal of Critical Care Medicine | Year: 2015

We report a case of "can ventilate but can't intubate" situation which was successfully managed in the Emergency Department and Intensive Care Unit by the use of ProSeal laryngeal mask airway and Frova Intubating Introducer as bridging rescue devices. Use of appropriate technique while strictly following the difficult airway algorithm is the mainstay of airway management in unanticipated difficult airway situations. Although the multiple airway devices were used but each step took not more than 2 min and "don't struggle, skip to the next step principle" was followed. With the availability of many advanced airway management tools, the intensivists should have a training and experience along with preparedness in order to perform such lifesaving airway managements.

Journal of Indian Academy of Forensic Medicine | Year: 2013

The northeastern state of Meghalaya is divided into eleven districts. It was carved out of Assam in 1972, with its capital at Shillong. The practice of Forensic Medicine in the state is still in its infancy. In most districts, medico-legal autopsy is performed by medical officers in Government service, who usually have no forensic qualifications, apart from a long history of exposure to the field. In recent years, there has been a spurt in crimes as well as increase in vehicular movement which resulted in more casualties due to road traffic accidents. Thus, a Government doctor not only has to manage sick patients but also face medico-legal challenges and conduct forensic examination in routine practice. At present, there are three qualified Forensic Specialists in Meghalaya. Health authorities have engaged their services to train medical officers in Government hospitals. However, this measure is inadequate to meet the state's forensic needs. Post-graduate medical courses in the subject would ensure a steady turnover of specialist doctors in this discipline. Meanwhile, forensic orientation programmes may be conducted more regularly to equip doctors in all districts with updated knowledge and skills to handle medico-legal cases.

Type: Journal Article | Journal: Heart Asia | Year: 2016

There are few reports on the primary percutaneous treatment of Lutembachers syndrome for which surgery has been the traditionally accepted modality of treatment. Concerns for percutaneous treatment in this entity are: (1) it is technically demanding and the dual lesion renders negotiation of catheters and balloons difficult; (2) redo valvulotomy in the presence of an atrial septal device would be difficult; (3) it may not be suitable for all patients with the condition. We describe percutaneous treatment by a hitherto undescribed technique of separate low septal puncture and review the existing literature.

Type: Case Reports | Journal: Indian journal of medical microbiology | Year: 2016

Chryseobacterium indologenes belongs to a group of nonfermentative Gram-negative bacilli and is an uncommon human pathogen. It causes severe infections such as septicaemia and ventilator-associated pneumonia in immunocompromised patients or after prolonged hospitalisation. We report a case of a noncatheter-related bacteraemia in a 22-year-old immunocompetent female whose blood culture showed the growth of C. indologenes, identified by Vitek GNI system (bioMerieux, France). The patient responded to treatment with ciprofloxacin. The pathogenicity and virulence factors of C. indologenes remain unclear. This case indicates that C. indologenes might cause symptomatic disease in immunocompetent persons with otherwise no associated underlying risk factors.

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