Browsing by Author "Prithwis Bhattacharya"

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Cerebral malaria caused by Plasmodium vivax in adult subjects
(Medknow Publications and Media Pvt. Ltd, 2008) Suman Sarkar; Prithwis Bhattacharya
Cerebral malaria is a diffuse encephalopathy associated with seizures and status epilepticus which can occur in up to one-third of patients with severe malaria, particularly that caused by Plasmodium falciparum. In this article, we report three cases of Plasmodium vivax malaria (all adult male patients) complicated by seizures and symptoms of diffuse meningoencephalitis. Two patients had predominantly meningeal signs, while in the third patient the features were purely of encephalitis All cases were treated with artesunate. Usually, cerebral malaria is caused by P. falciparum, and rarely, cerebral malaria is a presenting complication or occurs during the course of P. vivax infection.
Cerebrovascular manifestations and alteration of coagulation profile in scorpion sting: A case series
(Medknow Publications and Media Pvt. Ltd, 2008) Suman Sarkar; Prithwis Bhattacharya; Anil Paswan
Cerebrovascular manifestations are uncommon presentations of scorpion sting in the Indian subcontinent. A prospective study was carried out on 42 patients with scorpion sting in the intensive care unit (ICU) of the Institute of Medical Sciences, Banaras Hindu University, Varanasi-05, INDIA, during the period of May 2005 to October 2007. In all the patients detailed history, physical examination with a specific neurological examination and routine biochemical testing and fundus examination were done. Computerized tomography and magnetic resonance imaging were done in cases with neurological deficit. All these patients also underwent a complete hematological, rheumatologic and cardiovascular work-up for stroke. Cerebrovascular involvement was noted in three patients (7.15%). Hemorrhagic stroke was noted in two patients (4.77%) and thrombotic stroke was noted in one patient (2.39%). The mean time of presentation of neurological symptoms was 3 days. Contrary to world literature, there have been no reports of cranial nerve palsies or neuromuscular involvement in our series.
Changes of splanchnic perfusion after applying positive end expiratory pressure in patients with acute respiratory distress syndrome
(Medknow Publications and Media Pvt. Ltd, 2009) Suman Sarkar; Prithwis Bhattacharya; Indrajit Kumar; Kruti Mandal
Background: Positive end-expiratory pressure (PEEP) improves oxygenation and can prevent ventilator- induced lung injury in patients with acute respiratory distress syndrome (ARDS). Nevertheless, PEEP can also induce detrimental effects by its influence on the cardiovascular system. The purpose of this study was to assess the effects of PEEP on gastric mucosal perfusion while applying a protective ventilatory strategy in patients with ARDS. Materials and Methods: Thirty-two patients were included in the study. A pressure-volume curve was traced and ideal PEEP, defined as lower inflection point + 2cmH2 O, was determined. Gastric tonometry was measured continuously (Tonocap). After baseline measurements, 10, 15 and 20cmH 2 O PEEP and ideal PEEP were applied for 30 min each. By the end of each period, hemodynamics, CO2 gap (gastric minus arterial partial pressures), and ventilatory measurements were taken. Results: PEEP had no effect on CO2 gap (median [range], baseline: 18 [2-30] mmHg; PEEP 10: 18 [0-40] mmHg; PEEP 15: 17 [0-39] mmHg; PEEP 20: 16 [4-39] mmHg; ideal PEEP: 19 [9-39] mmHg; P = 0.19). Cardiac index also remained unchanged (baseline: 4.7 [2.6-6.2] l min1 m2 ; PEEP 10: 4.4 [2.5-7] l min 1 m2 ; PEEP 15: 4.4 [2.2-6.8] l min1 m 2 ; PEEP 20: 4.8 [2.4-6.3] l min1 m2 ; ideal PEEP: 4.9 [2.4-6.3] l min1 m2 ; P = 0.09). Conclusion: PEEP of 10-20 cmH2 O does not affect splanchnic perfusion and is hemodynamically well tolerated in most patients with ARDS, including those receiving inotropic supports.
Coexistence of Leptospirosis with Falciparum malaria
(Medknow Publications and Media Pvt. Ltd, 2007) Prithwis Bhattacharya; Arpan Chakraborty; Sahbaz Ahmed; Saswata Bharati
[No abstract available]
Comparison of intubating condition and cardiovascular effects after administration of rocuronium and vecuronium in children
(2008) Prithwis Bhattacharya; Shahbaz Ahmad; B.K. Behary; B.B. Kushwaha; P. Ranjan; P. Sharma
Background: Intubating conditions and cardiocascular effects of rocuronium and vecuronium were compared in children. Patients & Methods: The study was undertaken on 75 children aged 3-12 years of ASA grades I and II. They were randomly divided into three groups of 25 each. Group I (n=25) received bolus dose of vecuronium 0.1 mg kg-1, Group II received bolus dose of rocuronium 0.6 mg kg-1, and Group III received bolus dose of rocuronium 0.9 mg kg-1 as muscle relaxant to facilitate tracheal intubation. Comparison of intubating conditions and cardiovascular effects in all the three groups was done. Results: Vecuronium 0.1 mg kg-1 had a longer onset time than rocuronium 0.6 mg kg-1 and 0.9 mg kg -1, and provides better intubating conditions at 120 seconds. 0.9 mg kg-1 of rocuronium provides reliably excellent intubating conditions at 60 seconds than 0.6 mg kg-1 at 90 seconds. The changes in the hemodynamic parameters remained within clinically acceptable limits in all the three groups.
Comparison of outcome of self-extubation and accidental extubation in ICU
(Medknow Publications and Media Pvt. Ltd, 2007) Prithwis Bhattacharya; Arpan Chakraborty; Pawan Agarwal
Introduction: The study aimed to assess and compare the vulnerability and severity of outcomes in patients who suffered self-extubation and accidental extubation during their stay in the ICU. Design: Prospective observational study. Setting: Sixteen-bedded mixed intensive care unit in a tertiary care hospital. Materials and Methods: All adult patients admitted in ICU with either an endotracheal tube or a tracheostomy were included in the study. The time and description of the type of unplanned extubation, the cause and severity of the incident and its impact on the course of the patient's illness, the person who noted the incident first and how it was detected were noted. Results: The rate of unplanned extubation was 32 (1.42/100 tube days) in 552 intubated patients (2243 tube days). Of them, 26 patients suffered self-extubation while the rest six patients were accidentally extubated. Re-intubation was required in eight patients after self-extubation while it was needed in all the six patients of accidental extubation. Three patients of accidental extubation went on to develop respiratory arrest including one patient who developed cardiac arrest. Conclusion: The outcome of the patients who suffered self-extubation is better than those with accidental extubations.
Neurotoxic snake bite with respiratory failure
(Medknow Publications and Media Pvt. Ltd, 2007) Prithwis Bhattacharya; Arpan Chakraborty
Thirteen patients with severe neuroparalytic snake envenomation admitted in intensive care unit with respiratory failure over a four months period. Initially ptosis and ophthalmoplegia, followed by bulbar palsy and respiratory muscle weakness was the common sequele. All of them received cardio-respiratory support with mechanical ventilation, anti-snake venom (median dose of 20 vials) and anticholinesterase therapy. Except one suffering from hypoxic brain injury due to delayed presentation, rest survived with complete neurological recovery. So good outcome in such cases is related with early cardio respiratory support and anti venom therapy.
Successful management of massive intraoperative pulmonary fat embolism with percutaneous cardiopulmonary support
(Medknow Publications and Media Pvt. Ltd, 2008) Suman Sarkar; Krutisundar Mandal; Prithwis Bhattacharya
We report a patient who sustained catastrophic pulmonary fat embolism, during open reduction, internal fixation (ORIF) of fracture femur' In our opinion, the use of percutaneous cardiopulmonary support with (PCPS), saved the patient from certain death.