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Sardar T.,Nilratan Sirkar Medical College | Goswami A.K.,Nilratan Sirkar Medical College | Das Kundu S.,Nilratan Sirkar Medical College | Chatterjee S.,Bankura Sammilani Medical College | And 2 more authors.
Indian Journal of Forensic Medicine and Toxicology | Year: 2015

Gagging & chocking, both are types of violent asphyxial death. Gagging is mostly homicidal & majority of the victims are infants. Suicidal gagging is also reported many times from different parts of the world. Accidental gagging is relatively rare event. On the other hand, chocking is almost always accidental. Here, an accidental case of combination of gagging & chocking in a cannabis abuser has been reported. © 2015, Indian Journal of Forensic Medicine and Toxicology. All rights reserved.


Mukhopadhyay S.,Christian Medical College | Niyogi M.,Burdwan Medical College | Sarkar J.,Kothari Medical Center | Mukhopadhyay B.S.,Nilratan Sirkar Medical College | Halder S.K.,IQ City Medical College
Journal of Anaesthesiology Clinical Pharmacology | Year: 2015

Background and Aims: In absence of any published standard guideline for sedation or anesthesia practice for prolonged therapeutic "endoscopic retrograde cholangio-pancreatography (ERCP)," safe and cost-effective sedation protocol is the need of the hour. Our study aims to evaluate the efficacy of a dexmedetomidine as an add-on for prolonged deep sedation for ERCP and to compare three deep sedation regimens regarding safety and efficacy. Material and Methods: Forty-five consecutively enrolled patients planned for therapeutic ERCP and assumed to have prolonged procedural duration (>50 min) were divided into three groups in a randomized assessor blinded fashion. Group 1 received propofol and midazolam, Group 2 received the sedato-analgesic cocktail containing ketamine-propofol-midazolam-pentazocine, and the Group 3 received sedate-analgesic cocktail plus dexmedetomidine infusion under monitoring of vital parameters and according to the judgment of the concerned anesthesiologist. Total propofol requirement, episodes of gagging, oxygen desaturation, changes in mean blood pressure (MBP), recovery and satisfaction score of endoscopist, anesthetist and patient were noted and analyzed statistically using one way ANOVA with Bonferroni correction and Chi-square test. Results: Mean propofol requirement, incidences of gagging and oxygen desaturation was significantly less in Group 2 and 3 compared to Group 1. MBP was more stable and recovery was faster in Group 3. Anesthetist's satisfaction was more with Group 2 and even more with Group 3. Conclusions: The sedato-analgesic cocktail was superior to the conventional propofol-midazolam regimen, dexmedetomidine as add-on increased the efficacy and safety of sedate-analgesic cocktail. It reduces propofol requirement, helps to maintain the patient in a safe and more stable level of sedation and increases satisfaction of the anesthetist.


Basu K.,Nilratan Sirkar Medical College | Majumdar K.,Post Graduate Institute of Medical Education and Research | Chatterjee U.,Post Graduate Institute of Medical Education and Research | Ganguli M.,Consultant Pathologist | Chatterjee S.,Post Graduate Institute of Medical Education and Research
Indian Journal of Pathology and Microbiology | Year: 2010

En plaque meningioma is a rare type of meningioma characterized by infiltrative nature, sheet-like growth and at times invading the bone. We report here a case of en plaque meningioma with typical grade I histomorphology along with unusual feature of angioinvasion. The patient was a 55-year-old man presenting with headache and painful proptosis of right eye. Imaging modalities revealed an en -plaque meningioma extending into the right sylvian fissure, with thickening of right temporal calvarium, greater wing of sphenoid and extension into the orbit. Magnetic resonance angiography showed medial displacement of right middle cerebral artery. The tumor was removed from the sylvian fissure and right temporal convexity. However, only subtotal removal of the intraorbital part was possible. Histology showed a meningothelial meningioma with low tumor cell proliferation, but infiltration into the bone, skeletal muscle and angioinvasion. Recognition of meningiomas en plaque is useful, as these tumors are difficult to resect completely, and are more prone to undergo recurrence or malignant change. In addition, angioinvasion seen in this tumor may have additional prognostic significance.


Kundu M.,Indian Institute of Chemical Technology | Ghosh P.,Indian Institute of Chemical Technology | Mitra S.,Indian Institute of Chemical Technology | Das J.K.,Bank of The West | And 4 more authors.
Mutation Research - Fundamental and Molecular Mechanisms of Mutagenesis | Year: 2011

Genetic variants are expected to play an important role in arsenic susceptibility. Our previous study revealed deficient DNA repair capacity to be a susceptibility factor for arsenicism. T241M polymorphism in XRCC3 (a homologous recombination repair pathway gene) is widely studied for its association with several cancers. We have investigated the association of XRCC3 T241M polymorphism with arsenic-induced precancerous and non-cancer disease outcomes. The present study evaluated the association of T241M polymorphism with arsenic-induced skin lesions, peripheral neuropathy (neurodegenerative changes), conjunctivitis and other ocular diseases. A case-control study was conducted in West Bengal, India, involving 206 cases with arsenic-induced skin lesions and 215 controls without arsenic-induced skin lesions having similar arsenic exposure. XRCC3 T241M polymorphism was determined using conventional PCR-sequencing method. Chromosomal aberration assay, arsenic-induced neuropathy and ocular diseases were also evaluated. The data revealed that presence of at least one Met allele (Met/Met or Thr/Met) was protective towards development of arsenic-induced skin lesions [OR. =0.45, 95% CI: 0.30-0.67], peripheral neuropathy [OR. =0.49; 95%CI: 0.30-0.82] and conjunctivitis [OR. =0.60; 95%CI: 0.40-0.92]. A significant correlation was also observed between protective genotype and decreased frequency of chromosomal aberrations. Thus the results indicate the protective role of Met allele against the arsenic-induced skin lesions, chromosomal instability, peripheral neuropathy and conjunctivitis. © 2010 Elsevier B.V.

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