Browsing by Author "Surya Kumar Dube"

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Antitubercular drug poisoning in a pregnant woman
(2010) Rahul Dutta; Surya Kumar Dube; Dinesh Kumar Singh
A 20-year-old female in her third month of pregnancy, presented with generalised tonic clonic seizures, metabolic acidosis and coma following suicidal ingestion of antitubercular medication. We successfully managed the case with pyridoxine, sodium bicarbonate and mechanical ventilation.
Metabolic alkalosis: A less appreciated side effect of Imipenem-cilastatin use
(Wolters Kluwer Medknow Publications, 2013) Pragyan Swagatika Panda; Surya Kumar Dube; Suman Sarkar; Dinesh Kumar Singh
[No abstract available]
Metabolic alkalosis: A less appreciated side-effect of imipenem cilastatin use-author's reply
(Wolters Kluwer Medknow Publications, 2014) P.S. Panda; Surya Kumar Dube; Suman Sarkar; D.K. Singh
[No abstract available]
Outcome of severe falciparum malaria in an intensive care unit
(2011) Surya Kumar Dube; P.S. Panda; R. Dutta; A.P. Singh; D.K. Singh
Objective: Plasmodium falciparum infection is responsible for most malaria-related mortality and morbidity. We aimed at studying the initial clinical presentation and subsequent outcome of adult patients admitted to the ICU with severe falciparum malaria. Design: Prospective observational study. Setting: Intensive care unit of a 1300 bedded tertiary care hospital at Varanasi, India. Patients and participants: Patients aged more than 15 years fulfilling one or more of the WHO criteria for severe falciparum malaria were included. Intervention: All patients were managed as per the initial clinical presentation. Measurements and results: A total of 34 patients (23 males and 11 females) were included in the study. Twelve patients presented with coma, nine with shock, seven with generalized convulsions, four with ARDS, and the remaining two with spontaneous bleeding from multiple sites. Of these patients, seven survived from coma, two from shock, three from generalized convulsion, and one from ARDS. Twenty one patients died (12 from renal failure, five from multi-organ failure, and four from DIC) during their treatment in ICU, of whom 17 had on admission APACHE II score of >20. Of the 11 female patients, three were pregnant at the time of admission, all of whom died due to multi-organ failure. Conclusion: The most common mode of presentation of severe falciparum malaria was unarousable coma. Patients admitted to the ICU for neurological complications of malaria had a better prognosis than those admitted for other severe complications. APACHE II score can be a useful prognostic marker in cases of severe falciparum malaria. Renal failure was the most common cause of death in cases of severe falciparum malaria and was usually unresponsive to peritoneal dialysis.
Propofol requirement during propofol and butorphanol anesthesia with and without nitrous oxide in short duration intracranial surgeries: A bispectral index guided study
(2012) Surya Kumar Dube; Rajeev Kumar Dubey; Lal Dhar Mishra
Introduction: Propofol is a preferred agent in neurosurgical anesthesia because of its favorable effects on cerebral hemodynamics and excellent recovery profile. Butorphanol is a synthetic opioid which is 5-8 times more potent than morphine and is known to provide stable hemodynamics during various surgical procedures. Owing to its unfavorable effects on cerebral metabolism and hemodynamics nitrous oxide has a debatable role in neurosurgical anesthesia. But studies on exact dose requirement during propofol induction and maintenance anesthesia along with butorphanol with and without the use of N2O during craniotomies are lacking. So we aimed at studying the requirement of propofol (used along with butorphanol) with and without the use of nitrous oxide in intracranial surgeries using bispectral index (BIS) monitoring. Material and methods: Fifty ASA grade I/II patients (16-60 years) scheduled for elective intracranial surgeries (≤ 4 hour duration) were included and were randomly allocated into two groups, group P and PN. All received IV midazolam and butorphanol at a dose of 30 μg/kg each. Anesthesia was induced with propofol and maintained on propofol with oxygen in air (1:1 ratio) in group P and nitrous oxide in oxygen (2:1 ratio) in group PN patients. BIS score of ≤ 40 at the time of endotracheal intubation, 50-60 during maintenance and ≥ 70 at extubation was maintained. The overall and maintenance dose requirement of propofol and the recovery profile were studied. Results: The overall and maintenance propofol doses were significantly higher in group P than group PN (100.02 ± 20.28 μg/kg/min Vs 79.62 ± 13.13μg/ kg/min; p<0.001) and (90.82 ± 19.13 Vs 71.26 ± 11.78 μg/kg/min; p<0.001) respectively. The recovery profiles were identical between groups. Conclusion: When used along with butorphanol the overall and maintenance doses of propofol without the use of nitrous oxide are 100.02 ± 20.28 μg/ kg/min and 90.82 ± 19.13 μg/ kg/min respectively which is more (p<0.001) than the dose required in combination with nitrous oxide (79.62 ± 13.13 and 71.26 ± 11.78 μg/kg/min respectively). © 2012 Dube SK, et al.
Use of the pro-seal laryngeal mask airway facilitates percutaneous dilatational tracheostomy in an intensive care unit
(Wolters Kluwer Medknow Publications, 2010) Suman Sarkar; P. Shashi; Anil Kumar Paswan; R.P. Anupam; S. Suman; Surya Kumar Dube
Purpose: To study the feasibility of using the pro-seal laryngeal mask airway (LMA) for airway maintenance during bronchoscopic-guided percutaneous tracheostomy. Materials and Methods: Observational study of 60 patients in a 16-bed intensive care unit. The patient's tracheal tube was exchanged for a pro-seal LMA before undertaking percutaneous tracheostomy. Results: Inspiratory pressure and tidal volumes achieved during the procedure were recorded. The median peak inspiratory pressure was 25 (standard deviation 4.4) cm H2O. There was no loss of tidal volume in 30 patients, a loss of less than 100 mL/breath in 27, and loss of more than 100 mL in 3 patients. A pro-seal LMA successfully maintained the airway and allowed adequate ventilation during per-cutaneous tracheostomy in all 60 patients. In all patients, fiber optic bronchoscopy through the pro-seal LMA provided a clear view of the cords and trachea and there was no laryngeal or tracheal soiling at any stage of the procedure. Conclusion: The pro-seal LMA provides a reliable airway and allows effective ventilation during percutaneous tracheostomy. The passage of a fiberscope through the pro-seal LMA and glottis is easy and provides a clear view of the upper trachea.