Browsing by Author "Mehta, Hemant"
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Item Anaesthetic concerns of difficult airway in case of large oral hemangioma posted for robotic cystectomy(Medip Academy, 2020-09) Kapadia, Khevna; Shah, Sheetal; Mehta, Hemant; Mehta, MishaA difficult airway poses a challenge to attending anaesthesiologist. Fibreoptic intubation (FOI) to secure airway can be a valuable option in such a scenario. Steep Trendelenberg’s position with pneumoperitoneum in robotic surgery causes respiratory changes with airway oedema and congestion. We are describing here a case report of 56-year male patient with a large congenital oral cavity hemangioma with primary urothelial neoplasm of bladder posted for robotic radical cystectomy with ileal conduit with urethrectomy. We emphasize the importance of difficult airway management by using fibre optic technique in such cases complicated by steep Trendelenburg’s position required during robotic surgeries.Item Anaesthetic management of a patient with non compaction cardiomyopathy for implantable cardioverter defibrillator lead replacement(Medip Academy, 2020-08) Sharma, Kritika; Koli, Deepak; Daftary, Swati; Mehta, HemantNon compaction cardiomyopathy (NCM) is a rare, primary genetically derived cardiomyopathy with a variable clinical presentation ranging from absence of symptoms to congestive heart failure, systemic thromboembolism, arrythmias and sudden cardiac death. Being an uncommon condition, the perioperative concerns in a patient with NCM have not been studied much. With increasing awareness and improved diagnostic tools including high resolution echocardiography and cardiac MRI, there has been an increase in the reporting of cases which stresses on the need for a complete understanding of this form of cardiomyopathy and its perioperative anaesthetic management. Authors report the case of a 24 years old female, with NCM who underwent prophylactic Implantable cardioverter defibrillator (ICD) insertion 5 years ago and was now posted for ICD removal and replacement in view of inappropriate ICD functioning.Item Anesthetic management of pulmonary endarterectomy in a patient with suprasystemic pulmonary pressure: a case report(Medip Academy, 2020-06) Patel, Pravinkumar H.; Panthakey, Harvesp; Katkade, Sandip; Mehta, HemantPulmonary endarterectomy (PEA) is a potentially curative procedure for chronic thromboembolic pulmonary hypertension. A 34-year Indian male presented with supra-systemic pulmonary pressure was taken for PEA after achievable optimization. A successful PEA was performed with the help of total cardiac arrest. Patient developed reperfusion pulmonary edema post operatively, which was managed medically. The problems encountered by anesthesiologists in this case were preoperative pulmonary hypertension with chronic hypoxia and postoperative management of reperfusion pulmonary edema.Item A case of stress induced cardiomyopathy with extracorporeal membrane oxygenation after total colectomy(Medip Academy, 2019-10) Surwade, Sanjay Madhukar; Mandal, Tapas; Mehta, Hemant; Mangeshkar, ShaunakTakotsubo cardiomyopathy or stress-induced cardiomyopathy is a cardiac syndrome of a reversible, transient left ventricular dysfunction that is caused by emotional and/or physical stress and surgery. Its clinical manifestations are similar to acute myocardial ischemia in absence of coronary artery lesion. It is more common in middle-aged women, and the prognosis is favourable. We report the case of a 32-year-old male patient who underwent a total colectomy, developed stress-induced cardiomyopathy and had poor outcome despite extracorporeal membrane oxygenation (ECMO).Item Emergency open cholecystectomy in a patient with severe aortic stenosis under epidural anaesthesia(Medip Academy, 2019-08) Mishra, Roly; Sharma, Kritika; Mandal, Tapas; Panthakey, Harvesp; Mehta, HemantGoldman and colleagues identified severe aortic stenosis (AS) as a risk factor for perioperative cardiac complications in non-cardiac surgery. Although patients with aortic stenosis are at an increased risk of perioperative cardiac events, they can undergo non-cardiac surgery relatively safely provided that the condition is recognized and appropriate monitoring and management put in place. The early detection and treatment of hypotension and arrhythmias are essential. We present a case of severe aortic stenosis posted for emergency open cholecystectomy which was successfully managed under epidural anaesthesia and had an uneventful recovery.Item Learning habits evaluation of first m.b.b.s students of bhavnagar medical college.(2012-07) Shah, Chinmay; Patel, Shailesh; Diwan, Jasmin; Mehta, HemantBackground: The learning habit of a learner is the way he handles new information and experiences, and determines its outcomes. Various types of learning habits are adopted by students, including visual (V; learning from graphs, charts, and flow diagrams), auditory (A; learning from speech), read-write(R; learning from reading and writing), and kinesthetic (K; learning from touch, hearing, smell, taste, and sight).Understanding their preferred learning habits as visual, auditory, read-write or kinesthetic learners will help to improve the teaching methods adopted. Facilitators and supporters themselves may need guidance and training in how to identify feedback and adapt learning to individual's habits. Objective: To assess different learning habits of medical students and hence provide student oriented education, producing efficient doctors. Materials and Methods: This study was performed at Department of physiology in Govt. Medical College, Bhavnagar in March 2011.Eighty four (84) medical students of first MBBS were participated in the study. By using the English version of the visual, auditory, reading or writing, kinesthetic (VARK) questionnaire, we measured the difference in learning habits of First year medical students. Results: In Unimodal learning habit highest preference was given to auditory mode (48.57%), then to Kinesthetic (28.57%) & then to read (14.29%) & visual (8.57%). Among Multimodal learning habit students (n=44), 64.29% students preferred bimodal, 2.38% students preferred trimodal and 33.33% students preferred quadrimodal learning habit. Conclusion: Knowing that students have different preferred learning modes, will help medical instructors in our faculty develop appropriate learning approaches and explore opportunities so that they will be able to make the educational experience more productive. The results will help faculty to develop appropriate learning approaches and explore opportunities, so that they will able to make the educational experience more productive.Item Prone spine surgery in a morbidly obese patient: Anesthesia challenges and management(Mansa STM Publishers, 2022-06) Latkar, Prajakta; Kaushik, Prajwala S; Prabhudesai, Aaditya A; Mehta, HemantIndia is seeing a rapid epidemiological transition from underweight to overweight, with an overall prevalence of obesity reported to be 40.3%. Anesthesiology concerns in an obese patient are well known. We elaborate on the anesthesia management in a 68-year-old male patient with a body mass index of 66.3 kg/m2 who underwent spine surgery in prone position. Challenges faced ranged from the size of the table to the difficult airway, difficulty in positioning, maintenance of airway and ventilation, maintaining a free abdomen, and anesthesia management with meticulous use of anesthetic drugs for an uneventful recovery.Item Study Of Qtc Interval In Nondiabetic Subjects With Impaired Fasting Serum Glucose And Hyperinsulinemia(Society Of Medical Sciences, 2019-07) Makwana, Komal K.; Dinkar, Mukesh; Mehta, HemantINTRODUCTION: India leads the world with the largest number of diabetic subjects (nearly 40 million) and it is predicted that this number would reach almost 80 million by the year 2030. There are research works those indicate towards the genetic liability of Indians towards the insulin resistance, diabetes & obesity. The constellation of insulin resistance, impaired glucose tolerance, atherogenic dyslipidaemia, hypertension and intra-abdominal adiposity (IAA) is called metabolic syndrome. This all factors contribute to high cardiovascular risk, morbidity & mortality in population. Identification of cardiovascular risk in nondiabetic subjects at early stage might be a game changer. OBJECTIVE: The aims of our study were to evaluate the prevalence of QTc prolongation in nondiabetic subjects with impaired fasting serum glucose and hyperinsulinemia & identify the subjects with cardiovascular risks at early stage. METHOD: We estimated fasting serum glucose & insulin in multiple subjects till we found 50 nondiabetic subjects with impaired fasting serum glucose and hyperinsulinemia. For each case we matched 50 control without insulin resistance. Subjects’ heart beats were recorded on the resting ECG tracing. QTc was calculated according to Bazett’s formula. Insulin Resistance& hyperinsulinemia was defined as homeostasis model assessment of IR (HOMA-IR). RESULTS: We observed that there was significant difference in QTc interval between case & control group.CONCLUSION: This study has concluded that Insulin resistance, estimated by HOMA-IR, was strongly correlated with prolonged QTc. Prolonged QTc identifies metabolic syndrome patients with an elevated risk of cardiovascular eventsItem Transcutaneous pacing: a life saviour(Medip Academy, 2020-06) Mishra, Roly; Thakkar, Parna; Mehta, HemantDoukky Rand colleagues acknowledged that Transcutaneous Cardiac Pacing is a temporary method of pacing which may be indicated in patients with symptoms of severe or hemodynamically unstable bradyarrhythmias. It is found to be extremely helpful in patients with reversible or transient conditions, such as digoxin toxicity and in atrioventricular block in the case of inferior wall myocardial infarction, or when transvenous pacing is not available or there are high chances of complications. Widened QRS complex indicates successful attempt followed by a distinct ST segment and broad T wave. The hemodynamic response to pacing is to be confirmed by the assessment of patient’s arterial pulse waveforms. Trancutaneous pacing is a boon to manage and treat intra op dangerous bradycardia.