Papers by PRADIP KUMAR TIWARI
Introduction: Head and neck cancers are becoming more and more common and a definite protocol sho... more Introduction: Head and neck cancers are becoming more and more common and a definite protocol should be followed for its management. Different types of complications are generally seen during the treatment period related with both chemoradiation and surgery.We present a study of our experience in the management of outpatient department presenting with different types of post chemo-radiation and surgical complications. Present research was done to study the management different types of post chemo-radiation and surgical complications. Material and methods: A total of 213 patients were studied during the study period (Jun 14-Oct 15) in the, Department of Otolaryngology and Head and Neck Surgery, Assam Medical College, Dibrugarh, Assam. The same patients were treated in the study period. Different approaches like surgery, chemotherapy, radiotherapy and chemoradiation were used. Results: Head and neck carcinoma can present with a varied way of complications both before and after treatme...
Introduction: Although haemoglobinopathies are recognized all over the world, their frequency and... more Introduction: Although haemoglobinopathies are recognized all over the world, their frequency and distribution among different racial and ethnic groups show some peculiar endemicity. For example, sickle cell haemoglobin is mostly confined to the people of tropical Africa, thalassaemia in Mediterranean region and haemoglobin E is frequently seen among people of South-East Asia. Aim of the study was to study the different haemoglobin types in adolescents and the relation, if any, between the different types of haemoglobin and haemoglobin level in blood. Materials and Methods: 118 patients were studied in the study period. Co-relation between clinical findings, investigations and haemoglobin types were studied. It was a study of 118 patients, referred from various departments, presenting with different haemoglobin types between the study period of six months (March 2000 – Feb 2001) in the, Department of Physiology, Assam Medical College, Dibrugarh, Assam, India. Results: The study show...
Introduction: Porphyrias are a group of disorders caused by deficiency of the enzymes in heme bio... more Introduction: Porphyrias are a group of disorders caused by deficiency of the enzymes in heme biosynthetic pathway. Congenital erythropoietic porphyria "Gunther's disease" is an extremely rare disease with less than 200 cases documented worldwide. It is an autosomal recessive disease with mutation in the gene that codes for uroporphyrinogen III synthase. CEP is usually associated with hemolytic anemia. Case report: We herein report a case of two siblings with the typical presentation of photosensitivity, hypertrichosis, mutilation of the fingers, dark-purple urine, and erythrodontia with pinkish fluorescence under a Wood's lamp but without any feature of hemolysis. Conclusion: Very rarely CEP can present without any feature of hemolytic anemia. We report this case because of rarity.
Introduction: Levobupivacaine showed a lower risk of cardiovascular and central nervous system (C... more Introduction: Levobupivacaine showed a lower risk of cardiovascular and central nervous system (CNS) toxicity than bupivacaine which is the most popular local anesthetic agent in obstetric practice. The aim of this study was to compare the clinical effects (sensory block, motor block, hemodynamic effects, Apgar score at 1 and 5 minutes and adverse effects if any) of intrathecal 2.5 ml 0.5% isobaric levobupivacaine with 2.5 ml 0.5% hyperbaric bupivacaine in spinal anaesthesia for lower segment caesarean section. Material and Methods: 150 pregnant women in ASA I II group scheduled to have elective cesarean operation were allocated into the study. Patients were randomly divided into two groups. The combinations 12.5 mg levobupivacaine (0.5%) for Group L (n = 75) patients, 12.5 mg hyperbaric bupivacaine (0.5%) for Group B (n = 75) patients were intrathecally administrated a total of 2.5 cc. Sensory and motor block characteristics of the groups were assessed with pinprick and Modified Br...
Introduction: Throughout its course, the posterior tibial artery supplies numbers of perforators ... more Introduction: Throughout its course, the posterior tibial artery supplies numbers of perforators to the skin. This study is an attempt to find the anatomical location of the perforators related to posterior tibial artery in fresh cadaveric dissection as it is one of the main sources of artery having many septocutaneous or musculocutaneous perforators. Fasciocutaneous flaps can be harvested based on perforator arising from posterior tibial artery of lower limb and are used in lower limb defects Retrograde fasciocutaneous flap was performed in total ten cases with different variety of lower limbs defects based on lower two perforators arising from posterior tibial artery. Material and methods: The present study was carried out in the department of Anatomy in collaboration with department of Plastic surgery, Assam Medical College and Hospital, Dibrugarh, during the period from July 2015 to June 2016. A total number of 15 adult cadavers (30 lower limbs) of either sex were included in th...
Introduction: One of the sequence of anaesthesia is the post operative nausea and vomiting. nause... more Introduction: One of the sequence of anaesthesia is the post operative nausea and vomiting. nausea and vomiting post operative period is not only unpleasant and distressing,but a major factor in upsetting post operative convalescence. Hence the study was done to ascertain the role of ondansetron and metoclopramide in post operative nausea and vomiting,and their compararive efficacy in smoothening convalescence. Material and Methods: Prospective double blind randomized study was planed after institutional ethical committee clearance, 160 patients belonging to ASA class 1 and 2, and scheduled for general surgeries under general anaesthesia, were randomized into 4 (four)groups equally of 40 each, divided as placebo group, ondansetron 4mg, ondansetron 8mg and metoclopramide 10mg groups.The study drugs were given just prior to extubation and all parameters were noted. Statistical analysis was done by χ2 test i.e fourfold or 2x2 contigency table. Results: Ondansetron group showed less amo...
Introduction: Juvenile nasopharyngeal angiofibroma is a very rare, highly vascular, uncapsulated ... more Introduction: Juvenile nasopharyngeal angiofibroma is a very rare, highly vascular, uncapsulated and locally invasive tumor .Recently a changing trend has been seen in its epidemiology, pathogenesis, diagnosis, medical management, pre-operative care, surgical management and post-operative care including radiotHerapy. Atypical sites of juvenile nasopharyngeal angiofibroma is very rare. Management of atypical presentation of juvenile nasopharyngeal angiofibroma is complex and needs detailed evaluation and interdisciplinary approach. Case report: Case report with complete review of other studies along with comparative findings and different management approaches during the study periods was taken in account. The presentation and procedures to differentiate the late stages of atypical juvenile nasopharyngeal angiofibroma from other tumours was done. A single case of atypical juvenile nasopharyngeal angiofibroma was evaluated and treated. Age of presentation was 26 years and Stage IV of ...
Introduction: Porphyrias are a group of disorders caused by deficiency of the enzymes in heme bio... more Introduction: Porphyrias are a group of disorders caused by deficiency of the enzymes in heme biosynthetic pathway. Congenital erythropoietic porphyria "Gunther's disease" is an extremely rare disease with less than 200 cases documented worldwide. It is an autosomal recessive disease with mutation in the gene that codes for uroporphyrinogen III synthase. CEP is usually associated with hemolytic anemia. Case report: We herein report a case of two siblings with the typical presentation of photosensitivity, hypertrichosis, mutilation of the fingers, dark-purple urine, and erythrodontia with pinkish fluorescence under a Wood's lamp but without any feature of hemolysis. Conclusion: Very rarely CEP can present without any feature of hemolytic anemia. We report this case because of rarity.
Intoduction: Autoimmune diseases can be one of the important cause for the vocal cord dysfunction... more Intoduction: Autoimmune diseases can be one of the important cause for the vocal cord dysfunction. Many of those require surgical treatment. Vocal cord lesions with autoimmune diseases generally are indication for laryngeal microsurgery. Vocal cord dysfunction presents as a unique challenge to the anesthetists.Aim of the study was to conduct a study of laryngeal lesions along with autoimmune diseases and their management by microlaryngoscopy along with the anaesthetic challenges met. Material and method: The main objective being to highlight the management of autoimmune diseases along with laryngeal pathologies. A total of 147 patients were studied and out of which 7 cases were of autoimmune diseases and 6 were operated under general anaesthesia during the study period (Jul 14 – Sep15 ). Examination of all the patients was done to get results. Results: Vocal cord polys, nodules, Reinke’soedema, keratosis, papilloma, fibroangioma, endocrine small cell carcinoma of vocal cord etc were...
Introduction: In today’s era of immediate comfort and relief from the pain and sufferings the tec... more Introduction: In today’s era of immediate comfort and relief from the pain and sufferings the technology has found a better place in investigations and management of diseases. But, it must be remembered what the mind does not know the eyes cannot see. Therefore, there must be specific co-relation between the clinical findings and the investigations. Materials and methods: It was a retrospective study of 10 patients presenting with Gall bladder carcinoma between the study period of six months (May 2015 – Oct 2015) in the Department of Surgery, Assam Medical College, Dibrugarh, Assam, India. Ten patients were treated in the study period. Co-relation between clinical find ings and investigations were studied. Results: Radiological and other investigation showed an excellent co-relation with clinical findings. Conclusion: Investigational support is must for accurate diagnosis and treatment of gall bladder disorders.
Introduction: Nasopharyngeal carcinoma is a rare condition and has been linked to ethnicity and p... more Introduction: Nasopharyngeal carcinoma is a rare condition and has been linked to ethnicity and poor socio-economic condition. Meanwhile, there has been a change in its management protocol and though the complications have reduced the post-management complications have increased. We present a study of our experience in the management of out-patient department presenting with nasopharyngeal carcinoma. The aim of the study was to know the complications of nasopharyngeal carcinoma after chemo-radiation. Material and Method: It was a retrospective study of 14 patients presenting with Nasopharyngeal Carcinoma between the study period of one and a half year (Jan 2014 – Jun 2015) in the, Department of Otolaryngology and Head and Neck Surgery, Assam Medical College, Dibrugarh, Assam, India. Fourteen patients were treated in the study period. Different approaches like chemotherapy, radiotherapy and chemoradiation were used. Results: Nasopharyngeal carcinoma can present with a varied way of c...
Otolaryngology online journal, 2015
Hypothyroidism along with thyroid abscess is a very rare condition and not frequently encoun-tere... more Hypothyroidism along with thyroid abscess is a very rare condition and not frequently encoun-tered. It is an emergency as indicated with surgi-cal emphysema and hypothyroidism along with pneumothorax and pneumomediastinum. Esoph-ageal abscess and perforation along with pneu-mothorax ,pneumomediastinum and surgical cer-vical emphysema was diagnosed by HRCT NECK AND THORAX. The foreign body extruded after rupture of esophageal abscess and patient treat-ed for the underlying complications.
Intoduction: Dysphonia is the main symptom of lesions that affect the larynx. Many of those requi... more Intoduction: Dysphonia is the main symptom of lesions that affect the larynx. Many of those require surgical treatment. Vocal cord lesions are the most common and the most prevalent indication for laryngeal microsurgery. Aim: To conduct a study of laryngeal lesions and their management by microlaryngoscopy. Materials and methods:The main objective being to highlight the importance of microlaryngoscopy in the management of laryngeal pathologies. A total of 147 patients were studied and out of which20 cases were operated under general anaesthesiaduring the study period (Jul 14 – Jun15). History recording and full clinical examination of the patients, examination of blood, sputum for AFB, plain X-rays, CT scan, MRI, ECG were done. The largest possible laryngoscope was used. The working distance was 20 cm. Results: Patients undergoing microlaryngoscopy were diagnosed with vocal cord polys, nodules, Reinke’soedema, keratosis, papilloma, fibroangioma, endocrine small cell carcinoma of voc...
Introduction: "Otitis media with effusion " has been increasingly used in most of the r... more Introduction: "Otitis media with effusion " has been increasingly used in most of the recent literature and has become the current terminology, even though, the termeffusion does not differentiate purulent and non purulent. Materials and methods: It was a retrospective study of 100 patients presenting with hearing loss between the study period of one year (July 2001 to June 2002) in the Department of Otolaryngology and Head and Neck Surgery, Assam Medical College, Dibrugarh, Assam, India. Different approaches like myringotomy and aspiration, myringotomy and tympanostomy tube insertion, adenoidectomy and myringotomy and all combined. Results: A gain in hearing of more than 55% was seen in all the approaches. Surgical treatment like myringotomy and tympanostomy tube insertion restore the hearing impairment immediately. The possible etiological factors like adenoid hyperplasia, infected tonsils are better cured by surgery. Conclusion: The role of surgical treatment has become...
Introduction: An endonasal approach was attempted by West in 1910. The aim of this technique was ... more Introduction: An endonasal approach was attempted by West in 1910. The aim of this technique was to make a communication between the lacrimal sac and nose at a point just above the junction of the sac with the duct. In 1917, West modified Caldwell's technique with a window resection over the lacrimal sac but the results were mediocre. West and Polyak were the first ones to perform this surgery. The aim of the study was to find out the role of endoscopic dacryocystorhinostomy in acute dacryocystitis Material and methods: A prospective study was carried out in the Department of Otorhinolaryngology in conjunction with Department of Ophthalmology at Silchar Medical College and Hospital, Silchar for a period of one year on 9 patients. Results: 6 cases showed complete improvement of symptom and rest showed satisfactory improvement. Conclusion: Results are improving with the use of modern endoscopes, microsurgical instruments and lasers with a similar success rate to conventional exter...
Introduction: Squamous cell carcinoma of sinonasal cavity with oronasal fistula is a very rare co... more Introduction: Squamous cell carcinoma of sinonasal cavity with oronasal fistula is a very rare complication and the previous case reports on this condition have cited surgery to be a better option for treatment followed by radiotherapy and chemotherapy. Aim : To correlate the findings of our study with the other works done for this condition Case report: Radiotherapy is an important tool in the treatment of cancer. The patient presented with bleeding from a sinonasal growth .The diagnosis was made by HRCT of faciomaxillary region. Squamous cell carcinoma melted like snow with radiotherapy and chemotherapy was given and the patient was further planned for surgery. Conclusion : Radiotherapy and chemotherapy followed by surgery is a better option for the treatment of sinonasal carcinoma.
Hypothyroidism along with thyroid abscess is a very rare condition and not frequently encountered... more Hypothyroidism along with thyroid abscess is a very rare condition and not frequently encountered. It is an emergency as indicated with surgical emphysema and hypothyroidism along with pneumothorax and pneumomediastinum. Esophageal abscess and perforation along with pneumothorax ,pneumomediastinum and surgical cervical emphysema was diagnosed by HRCT NECK AND THORAX. The foreign body extruded after rupture of esophageal abscess and patient treated for the underlying complications.
Introduction: One of the sequence of anaesthesia is the post operative nausea and vomiting. nause... more Introduction: One of the sequence of anaesthesia is the post operative nausea and vomiting. nausea and vomiting post operative period is not only unpleasant and distressing,but a major factor in upsetting post operative convalescence. Hence the study was done to ascertain the role of ondansetron and metoclopramide in post operative nausea and vomiting,and their compararive efficacy in smoothening convalescence. Material and Methods: Prospective double blind randomized study was planed after institutional ethical committee clearance, 160 patients belonging to ASA class 1 and 2, and scheduled for general surgeries under general anaesthesia, were randomized into 4 (four)groups equally of 40 each, divided as placebo group, ondansetron 4mg, ondansetron 8mg and metoclopramide 10mg groups.The study drugs were given just prior to extubation and all parameters were noted. Statistical analysis was done by χ2 test i.e fourfold or 2x2 contigency table. Results: Ondansetron group showed less amo...
Journal of Head Neck & Spine Surgery
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Papers by PRADIP KUMAR TIWARI