Browsing by Author "Banerjee, Amit"
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Item Acute normovolemic hemodilution is not beneficial in patients undergoing primary elective valve surgery.(2010-01) Virmani, Sanjula; Tempe, Deepak K; Pandey, Bhuvan C; Cheema, Amandeep S; Datt, Vishnu; Garg, Mukesh; Banerjee, Amit; Wadhera, AshooThe objective of this study was to evaluate the effectiveness of acute normovolemic hemodilution (ANH) as a sole method of reducing allogenic blood requirement in patients undergoing primary elective valve surgery. One hundred eighty eight patients undergoing primary elective valve surgery were prospectively randomized into two groups: Group I (n=100) acted as control and in Group II (n=88) autologous blood was removed (10% of estimated blood volume in patients with hemoglobin (Hb) >12g% and 7% when the Hb was <12g%) in the pre-cardiopulmonary bypass (CPB) period for subsequent re-transfusion after protamine administration. The autologous blood withdrawn was replaced simultaneously with an equal volume of hydroxyl-ethyl starch solution. Banked blood was transfused in both the groups when Hb was ≤6g % on CPB and ≤8g% after CPB. Platelets were transfused when the count fell to <100´10 9 /L and fresh frozen plasma (FFP) was transfused whenever there was diffuse bleeding with laboratory evidence of coagulopathy. The two groups were comparable as regards demographic data, type of surgical procedures performed, duration of CPB and ischemia, duration of elective ventilation and re-exploration for excessive bleeding. The autologous blood withdrawn in patients with Hb≥12g% was 288.3±69.4 mL and 244.4±41.3 mL with Hb<12g% (P=NS). The Hb concentration (g %) was comparable pre-operatively (Group I= 12.1±1.6, Group II= 12.4±1.4), on postoperative day 1 (Group I =10.3±1.1, Group II= 10.6±1.2) and day 7 (Group I = 10.9±1.5, Group II=10.4±1.5). However, the lowest Hb recorded on CPB was significantly lower in Group II (Group I =7.7±1.2, Group II=6.7±0.9, p0 <0.05). There was no difference in the chest tube drainage (Group I =747.2±276.5 mL, Group II=527.6±399.5 mL), blood transfusion (Group I=1.1±1.0 units vs. Group II=1.3±1.0 units intra-operatively and Group I=1.7±1.2 units vs. Group II=1.7±1.4 units post-operatively) and FFP transfusion (Group I =581.4±263.4 mL, Group II=546.5±267.8 mL) in the two groups. We conclude that low volume autologous blood pre-donation does not seem to provide any added advantage as a sole method of reducing allogenic blood requirement in primary elective valve surgery.Item Anaesthetic Considerations for Noncoronary Surgery on a Perfused Beating Heart under Cardiopulmonary Bypass.(2002-01-25) Tomar, Akhlesh S; Banerjee, Amit; Hazari, Kunal; Chaudhary, Jeevesh; Virmani, Sanjula; Tempe, Deepak KMyocardial revascularisation on a beating heart with or without cardiopulmonary bypass has significantly reduced the incidence of cardioplegic myocardial injury. With this advantage in view, noncoronary open heart surgery was performed on a beating heart under cardiopulmonary bypass. We discuss the anaesthetic management of such cases. Thirty-three patients aged 14-56 years underwent open heart surgery on a perfused beating heart. Eleven of them underwent open mitral valvotomy, eighteen underwent mitral valve replacement, repair of atrial septal defect was performed in 3 patients and one had removal of left atrial myxoma. Cardiopulmonary bypass was instituted with aortic and bicaval cannulation. At normothermia, aorta was cross-clamped and continuous coronary perfusion was maintained through an aortic root needle at a rate of 4-6 mL/Kg/minute facilitating a beating heart. Trans-oesophageal echocardiography was routinely deployed. Anaesthetic considerations were focused towards the maintenance of the beating state of the heart, that included, strict control of electrolyte balance, maintenance of adequate perfusion pressure and ST segment monitoring. All the patients could be weaned off cardiopulmonary bypass without defibrillation or significant inotropic support. There was no operative mortality. Open heart surgery on a beating heart for non-coronary cardiac conditions appears to be a good and reproducible option to protect the myocardium from deleterious effects of cardioplegic arrest.Item Anesthetic management for emergency cesarean section and aortic valve replacement in a parturient with severe bicuspid aortic valve stenosis and congestive heart failure.(2010-01) Datt, Vishnu; Tempe, Deepak K; Virmani, Sanjula; Datta, Devesh; Garg, Mukesh; Banerjee, Amit; Tomar, Akhlesh SAsymptomatic women with mild aortic stenosis (AS) and normal left ventricular functions can successfully carry pregnancy to term and have vaginal deliveries. However, severe AS (valve area <1.0cm 2 ) can result in rapid clinical deterioration and maternal and fetal mortality. So, these patients require treatment of AS before conception or during pregnancy preferably in the second trimester. In suitable patients percutaneous balloon aortic valvutomy appears to carry lower risk. It can also be used as a palliative procedure allowing deferral of aortic valve replacement until after delivery. The present patient had severe critical AS with congestive heart failure that was refractory to medical therapy and the fetus was viable (>28wks). So, combined lower segment cesarean section and aortic valve replacement were performed under opioid based general anesthesia technique to reduce the cardiac morbidity and mortality.Item Anesthetic management of patient with myasthenia gravis and uncontrolled hyperthyroidism for thymectomy.(2010-01) Datt, Vishnu; Tempe, Deepak K; Singh, Baljit; Tomar, Akhlesh S; Banerjee, Amit; Dutta, Devesh; Bhandari, HrichaThe relationship between myasthenia gravis (MG) and other autoimmune disorders like hyperthyroidism is well known. It may manifest earlier, concurrently orafter the appearance of MG. The effect of treatment of hyperthyroidism on the control of MG is variable. There may be resolution or conversely, deterioration of the symptoms also. We present a patient who was diagnosed to be hyperthyroid two and half years before the appearance of myasthenic symptoms. Pharmacotherapy for three months neither improved the myasthenic symptoms nor the thyroid function tests. Thymectomy resulted in control of MG as well as hyperthyroidism. In conclusion, effective control of hyperthyroidism in the presence of MG may be difficult. The authors opine that careful peri-operative management of thymectomy is possible in a hyperthyroid state.Item Anomalous connection of superior vena cava to the left atrium masquerading as epilepsy: a case report with review of literature.(2008-01-10) Singh, Sandeep; Geelani, Muhammed Abid; Modi, Pranav; Niwaria, Yogesh; Shahi, Sudhir; Banerjee, AmitAn 11-year-old girl who presented with recurrent epileptic fits was eventually found to have a superior vena cava draining into the left atrium. There was no atrial septal defect. The patient underwent a successful surgical correction.Item Anomalous drainage of the right superior vena cava into the left atrium.(2004-01-08) Mukhopadhyay, Saibal; Mehta, Vimal; Yusuf, Jamal; Rastogi, Vishal; Banerjee, Amit; Trehan, VijayItem Anticoagulation for pregnant patients with mechanical heart valves.(2007-07-25) Srivastava, Aseem R; Modi, Pranav; Sahi, Sudhir; Niwariya, Yogesh; Singh, Harpreet; Banerjee, AmitManagement of a pregnant patient with mechanical heart valve is a complex issue for all health care providers involved in the care of such patients. Complications may arise at any stage due to the increased haemodynamic load imposed by pregnancy or because of impaired cardiac performance often seen in these patients. In addition, the use of various cardiovascular drugs in pregnancy (especially anticoagulants) may lead tofoetal loss or teratogenic complications. Additionally, the risk of thrombo-embolic complications in the mother is increased by the hypercoagulable state of pregnancy. In this review, we have attempted to draw inferences to guide management of such patients based on the available literature. It seems that in pregnant women with mechanical heart valves, recent data support warfarin use throughout pregnancy, followed by a switch to heparin and planned induction of labour. However, the complexity of this situation demands a cafeteria approach where the patient herself can choose from the available options that are supported by evidence-based information. Unfortunately there is no consensus on such data. An overview of the available literature forms the basis of this review. In conclusion, a guideline comprising pragmatic considerations is preffered.Item Atrial ECG as a guide to the placement of central venous catheter in patients undergoing Open Heart Surgery.(2003-01-11) Tempe, Deepak K; Virmani, Sanjula; Tomar, A S; Datt, Vishnu; Aggarwal, Nisheet; Yadav, Satyendra; Narang, Poonam; Minhas, Harpreet S; Banerjee, AmitHundred adults undergoing open heart surgery were randomized into two equal groups. In group I (n=50), surface anatomical landmarks and in group II (n=50) atrial ECG was used as a guide for correct placement of the central venous catheter (within 1 cm of superior vena cava - right atrial junction). The position of the catheter tip was confirmed by direct palpation by the surgeon on the operating table and by radiological examination in the post operative period. Surgeon's assessment revealed that the catheter was successfully placed in 32 (69.6%) patients in group II and 25 (50%) patients in group I (p=NS). Radiological examination revealed that the catheter was successfully placed in 31 (67.4%) patients in group II and in 28 (57.1%) patients in group I (p=NS). Amongst the unsuccessful placements right atrial placement was present in 5 patients (10%) in group I and 7 patients (15.2%) in group II by surgeon's assessment and 8 patients (16.3%) in group I and 9 patients (9.6%) in group II by radiological examination (p=NS) No complications related to intracardiac placement occurred in any of the patients. We conclude that atrial ECG is a promising technique for central venous catheter placement, although it did not significantly increase the correct placement in this study. This may be due to alteration in the relationship of sino-atrial node and superior vena cava - right atrial junction in patients with cardiac disease. Further studies defining the correct technique of insertion, (especially in cardiac patients) are necessary to improve the success rate.Item Choardae tendineae from posteromedial papillary muscle inserting into the anterior mitral leaflet--an unusual presentation.(2007-01-26) Tempe, Deepak K; Datt, Vishnu; Banerjee, Amit; Gandhi, AshishItem A Comparative Study Of Physiological Variables Among Rural And Urban Football Players Of Murshidabad District(Indian Society for Health and Advanced Research, 2023-06) Deb, Avijit; Banerjee, AmitFitness is the term, which is universally used in the present-day health responsive society. The people have realized the importance of fitness in day-to-day routines and also in achieving sports of high quality. The main purpose of the study was to find out some Physiological Variables of Rural and Urban Football Players Only college level male subjects were selected the age groups of the subjects were above 18 to 22 years. Some physiological variables (Vital capacity, Blood pressure, Pulse rate, Resting Heart rate, Haemoglobin, Breath holding Capacity) were measured. For the present study 20 subjects from each group were selected as subjects. The result shows that rural football players are larger than urban football players in terms of physiological variables.Item Comparative-study-on-selected-psychological-abilities-between-kabaddi-and-kho-kho-players(Indian Society for Health and Advanced Research, 2023-03) Deb, Avijit; Banerjee, AmitThe main objective of the current study was to compare the kabaddi and Kho-Kho players of Murshidabad district, who was attained position at district level sports competition on selected psychological abilities through the selected test items such as: psycho-motor Ability, Concentration and sports Competition Anxiety Test between the players of kabaddi and Kho-Kho. For the purpose of the present study, finally sixty players were selected as subject. Out of total sixty subject, 30 subjects from the Kho-Kho have been selected on purposive and random sampling basis, who was won medal/position district level sports competition. All the subjects were involved in regular practise as a preparation for their targeted competition in their own sports. The data ware collected in raw from and analysed by calculating the descriptive statistical techniques and 't' test were applied. The level of significance was set at 0.05 level of confidence. There was significant difference was found in the Psycho-motor Ability in relation to the Kabaddi and Kho-Kho players. There was no significant difference found in relation to consultation ability measured through great taste between Kabaddi and Kho-Kho players. The significant difference watch found in the sports competition hello anxiety test (SCAT) in relation to the Kabaddi and Kho-Kho playersItem Congenital lobar emphysema: Pitfalls and management.(2010-01) Tempe, Deepak K; Virmani, Sanjula; Javetkar, Swati; Banerjee, Amit; Puri, Sunil Kumar; Datt, VishnuCongenital lobar emphysema is a rare entity presenting in the first month of life. It appears with varying degrees of respiratory distress, clinical and radiological evidence of over-aeration of the upper and middle lobes, mediastinal shift and hypoxia. Its early recognition and surgical intervention can be life-saving. Even today, despite advanced diagnostic techniques, pitfalls in diagnosis and management are not uncommon and the condition may be mistaken for pneumothorax or pneumonia. This report elucidates the anesthetic management of three such cases with a review of literature.Item Congenital tricuspid stenosis and membranous right ventricular outflow tract obstruction in an adult.(2003-07-11) Mehta, Vimal; Sengupta, Partho P; Banerjee, Amit; Arora, Ramesh; Datt, VishnuItem Effect Of Aerobic Training On Selected Physiological Variables Amongst Inter Collegiate Level Netball Players(Indian Society for Health and Advanced Research, 2023-06) Deb, Avijit; Banerjee, AmitThis study explored the result of aerobic training on selected physiological variables amongst inter collegiate level netball players. Thirty male netball players were selected as subjects. Tre age of the subjects ranged from 20 to 25 years. The selected subjects were haphazardly separated into two groups with fifteen subjects in each group (n=15). The groups were named experimental group and control group The experimental group underwent an aerobic training program for the duration of six weeks. The collected data was statistically analysed through using request paired 't' tests. The results of the present study have powerfully indicated that participation in six weeks of aerobic training program resulted in important differences on selected physiological variables.Item Effect of muscle relaxants on heart rate, arterial pressure, intubation conditions and onset of neuromuscular block in patients undergoing valve surgery.(2006-01-19) Virmani, Sanjula; Tempe, Deepak K; Datt, Vishnu; Tomar, A S; Banerjee, Amit; Minhas, Harpreet Singh; Goel, SanjaySixty six patients undergoing elective valve surgery were randomized to receive rocuronium bromide 0.6 mg/Kg (Group R, n=22), pancuronium bromide 0.1 mg/Kg (Group P, n= 22) and vecuronium bromide 0.1 mg/Kg (Group V, n=22), Measurements of heart rate and arterial pressure (systolic, diastolic and mean) were noted at the following stages: 1) baseline when haemodynamics were stable for 2 minutes after induction of anaesthesia (2) one, (3) three, (4) five minutes after administration of muscle relaxants, (5) One, (6) three, and (7) five minutes after intubation. In group R, the heart rate decreased 5 min after injection of muscle relaxant from 93.9 +/- 21.3 to 82.4 +/- 20.7 beats/min (p<0.001). However, it increased to 128.3 +/- 25.8 beats/min (p<0.001) following intubation and returned to baseline at 5 min after intubation. In group P, heart rate increased from 98.8 +/- 32.6 to 109.6 +/- 32.7 beats/min (p<0.001), 1 min after injection of pancuronium and this increase persisted throughout the study period. In group V, heart rate decreased from 99.9 +/- 22.3 to 83.8 +/-19.6 beats/min (p<0.001) at 5 min after injection of the drug. It increased to 118.6 +/- 22.4 beats/min (p<0.001), 1 min after intubation and returned to baseline at 5 min after intubation. The decrease in heart rate in group R and V was accompanied by a significant decrease in systolic, diastolic and mean arterial pressure. In group P, only the systolic pressure decreased significantly at 5 min after injection of the drug. Intubation was accompanied by a significant increased in systolic, diastolic and mean arterial pressure in all the groups. Excellent intubation conditions (intubation score 3-4) were observed with all the three drugs, however, there were number of patients in group P who showed diaphragmatic movement during intubation. Onset of action of muscle relaxant, was fastest with rocuronium (group R=132.7 +/- 0.3 sec, P=182.6 +/- 68.5 sec, V= 144.8 +/- 46.1 sec, Group P vs Group R). To conclude, pancuronium causes significant increase in heart rate and should be preferred in patients with regurgitant lesions having slower baseline heart rate. Vecuronium and rocuronium decrease the heart rate and should be preferred in patient with faster baseline heart rate. In terms of intubating conditions rocuronium and vecuronium provide best conditions, but onset is faster with rocuronium.Item Firefighters' boot: angiocardiographic appearance of an unruptured aneurysm of the sinus of valsalva.(2004-01-11) Betigeri, Vithal Kumar; Banerjee, Amit; Sharma, Vinita; Nagesh, A; Sreedhar, K Satya; Trehan, Vijay KItem Forequarter amputation with innocuous bronchopleurocutaneous fistula following high tension electric burn.(2008-10-28) Narang, Sumit; Mishra, B B; Singh, Harpreet; Banerjee, AmitItem Intraoperative endocardial ablation of chronic atrial fibrillation along with mitral valve surgery using high frequency ultrasound with a ball-tipped harmonic scalpel probe.(2004-03-21) Banerjee, Amit; Singh, Sandeep; Tempe, Deepak KItem Mitral valve surgery through the left atrial appendage.(2004-07-11) Sridhar, K Satya; Betigeri, Vithalkumar M; Sharma, Vinita; Datt, Vishnu; Banerjee, AmitItem Mobile left atrial mass.(2013-07) Tempe, Deepak K; Dutta, Devesh; Saigal, Deepti; Banerjee, Amit