Browsing by Author "Biswajit Mishra"

Now showing 1 - 4 of 4

Demonstration of live lymphatic circulation in the deep fascia and its implication
(2011) Visweswar Bhattacharya; Gaurab R. Chaudhuri; Biswajit Mishra; Umesh Kumar
It is well known that vascular arcades and lymphatic networks co-exist all over the body with distinct physiological functions complimentary to each other. We visualized lymphatics in the deep fascia under electron microscope using 4000 magnification. Encouraged by our previous research with demonstration of live microcirculation in the deep fascia, we successfully explored the possibility of demonstrating live lymphatic circulation. The fascial extension of inferiorly based fasciocutaneous flaps were dissected in five patients with distal leg defects. The fascial extension was mounted on a glass slide and examined under microscope using 600 magnification (x40 lens). We witnessed live microcirculation as well as live lymphatic circulation in the same field of observation with specific characteristics. A video recording was made to document these important features which to the best of our knowledge is not mentioned in the literature. The theme of this study is to explain, how by incorporating the deep fascia in the flap, besides vascularity, other physiological functions are augmented. © Springer-Verlag 2010.
Effect of surgical traumas on microcirculation
(2009) Visweswar Bhattacharya; Biswajit Mishra; Binayak Mishra; Umesh Kumar; Siddhartha Bhattacharya
Background: Adequate microcirculation in different tissues maintains the physiological function and heals surgical wounds. In any surgical procedure, the commonly used instruments are cautery, tissue forceps, and clamps. The fact that their inappropriate use produces an adverse effect on microcirculation is often not realized. By this study, we could demonstrate live, the effect of these surgical traumas. Methods: The study was conducted on the inferiorly based fasciocutaneous flap with a fascial extension in patients with a distal leg defect. The extended fascial flap was mounted on a glass slide and observed for live microcirculation under x160 magnification. Three methods were used: (a) cautery in low power, (b) microcrushing forceps to crush the vessels, and (c) noncrushing clamps at the base of the fascial flap. Results: It was observed that the vessels are well protected within the deep fascia. Once the fascia was pierced the current damaged the vessel wall. As the wattage was increased, it caused charring of the tissue and multiple vessels ultimately leading to cessation of blood flow. Once the vessel wall was crushed by forceps, blood extravasated in a variable intensity depending upon the size of the vessel. Clamping led to gradual slowing of blood flow with microclot formation. In certain vessels, there was discontinuity in the blood column and ultimately the blood flow stopped. Conclusion: This study showed live demonstration of the effect of surgical traumas on microcirculation. It should guide the surgeons to select the use of appropriate instruments which will cause minimal damage to vascularity and thereby lead to a better surgical outcome.
Lymphangiectasis of lower limb: A rare challenging case
(2009) Visweswar Bhattacharya; Biswajit Mishra; Partha Barooah; Gaurab Ranjan Chaudhuri; Siddhartha Bhattacharya
Lymphangiectasis usually occurs in the viscera. Involvement of the lower limb is very rare. It is difficult to establish the diagnosis without detailed investigations. Clinical features are peculiar and may mimic lymphoedema of different origins which needs to be ruled out. Contrary to the expectation, the post-operative result is excellent in the long-term follow-up.
Tripod-shaped Syndactyly in Apert Syndrome with FGFR2 pP253R Mutation
(Georg Thieme Verlag, 2021) Chandra Bhan Singh; Biswajit Mishra; Rashmi Patel; Ashok Kumar; Akhtar Ali
Apert syndrome is a rare acrocephalosyndactyly (craniosynostosis) syndrome characterized by craniofacial dysmorphism and syndactyly of the hands and feet. It is caused by FGFR2 mutations and inherited in an autosomal dominant manner. This article describes a novel clinical variant of Apert syndrome having bilateral symmetrical tripod-shaped syndactyly in hands with milder craniofacial features in a sporadic case, along with a mutation in the fibroblast growth factor receptor 2 (FGFR2) gene. The patient had shown craniosynostosis, dysmorphic face, ocular hypertelorism, marked depression of the nasal bridge, long philtrum, and low set ears. Direct resequencing of the FGFR2 gene through Sanger's method identified a heterozygous missense mutation; FGFR2c.758C>G (FGFR2p.P253R) in the exon-7 of the gene. © 2021 Georg Thieme Verlag. All rights reserved.