Effects of intrathecal dexmedetomidine as an additive to low-dose bupivacaine in patients undergoing transurethral resection of prostate.

Background And Aims: In patients undergoing transurethral resection of prostate (TURP), it is vital to restrict the level of block to Tdermatome during spinal anaesthesia. Low-dose bupivacaine causes minimum haemodynamic alterations, but may provide insufficient surgical anaesthesia. Dexmedetomidine, a selective α-adrenoreceptor agonist, is a potent anti-nociceptive agent when given intrathecally.

Current Scenario of Hepatitis B and Its Treatment in India.

Hepatitis B is a significant public health problem in India, yet disease awareness is very low among the general population. The disease is mostly acquired horizontally, but the role of vertical transmission should not be underestimated. In spite of the fact that the majority of cases are e negative disease, most patients present in the advanced stage and even with hepatocellular carcinoma, the leading cause of which is hepatitis B.

Diffuse Idiopathic Skeletal Hyperostosis Involving Cervical and Lumbar Spine Presenting with Dysphagia: A Case Report.

Introduction: Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a very rare cause of dysphagia when it occurs in the cervical spine. It can also affect the lumbar region where it causes deformity.

Case Report: In this article, a rare case of Diffuse Idiopathic Skeletal Hyperostosis involving both the cervical and lumbar spine, presenting with dysphagia and spinal stiffness leading to a stooping posture, is reported.

Laparoscopic cholecystectomy in a case of situs inversus totalis: a review of technical challenges and adaptations.

Situs inversus totalis is a rare congenital condition, characterized by the transposition of the thoracic and abdominal viscera, resulting in a mirror image of normal anatomy. Even though situs inversus does not predispose to gall stones, a laparoscopic cholecystectomy, in a case of situs inversus, can prove to be a technically challenging procedure, especially for the right-handed surgeon. In this case report, we present an unusual case of cholelithiasis in a patient with situs inversus totalis.

Tolosa-Hunt Syndrome and Ocular Myasthenia: A Rare Coexistence or Real Association.

Tolosa- Hunt syndrome is a rare steroid responsive disorder caused by granulation tissue involving the cavernous sinus or superior orbital fissure presenting as painful ophthalmoplegia and facial pain. In this report, we describe coexistence of Tolosa-Hunt syndrome with ocular myasthenia which may point towards an autoimmune etiological basis behind the cavernous sinus granulation tissue formation and also offered therapeutic challenge to ameliorate the symptoms.

Inflammatory bowel disease in India - Past, present and future.

There is rising incidence and prevalence of inflammatory bowel disease (IBD) in India topping the Southeast Asian (SEA) countries. The common genes implicated in disease pathogenesis in the West are not causal in Indian patients and the role of "hygiene hypothesis" is unclear. There appears to be a North-South divide with more ulcerative colitis (UC) in north and Crohn's disease (CD) in south India.

Hashimoto's Encephalopathy Presenting with Chorea.

Hashimoto's encephalopathy (HE) is a steroid-responsive relapsing neuropsychiatric disorder associated with high titers of antithyroid antibody with or without thyroid dysfunction. We report a case of HE in a 78 year old female who developed sudden onset behavioral abnormalities associated with choreiform movement of extremities. All causes of vascular, infective, metabolic, autoimmune, paraneoplastic and toxic encephalopathy were excluded.

5-year efficacy of entecavir in Indian patients with chronic hepatitis B.

Background: Entecavir, a drug with high potency and genetic barrier against hepatitis B virus, was believed to become very effective in reducing the hepatitis B burden in India. Long-term studies on its treatment outcome are scarce.

Methods: One hundred and six chronic hepatitis B (CHB) patients (17 cirrhotics of Child class A/B) who received entecavir therapy (0.

Evaluation of the Symptom of Constipation in Indian Patients.

Introduction: The exact prevalence of constipation in India is unknown. To know this, first it has to be properly defined based on stool frequency and form (as in western definition) in Indian patients, data on which is scarce. There may be difference with the western definition also.

Angioplasty of unprotected left main coronary stenosis: Real world experience of a single-operator group from eastern India.

Background: Coronary artery bypass graft surgery is the standard treatment of unprotected left main coronary stenosis (ULMCA). However, in the real world scenario, many of these patients are unfit for CABG or prefer angioplasty as an alternative when offered the choice.

Methods: A total of 86 clinically stable patients with ULMCA stenosis who were unfit or unwilling for CABG underwent PCI with DES at two tertiary care centers in Kolkata.

Anti-Neutrophil Cytoplasmic Antibody (ANCA)-Negative Small Vessel Vasculitis: A Rare Cause of Pulmonary Renal Syndrome.

Pulmonary renal syndrome (PRS) is characterized by both diffuse alveolar haemorrhage and glomerulonephritis as pathological features. Several immunologic and non-immunologic mechanisms including anti-neutrophil cytoplasmic antibody (ANCA)-positive vasculitis, anti-glomerular basement membrane disease, and systemic lupus erythematosus are commonly involved in the pathogenesis of the syndrome. We herein present a 60-year-old woman, non-smoker, who presented with fever, polyarthralgia, and the spreading of generalized purpuric rashes.

Quality of Life and Clinical Response to On-Demand Maintenance Doses of Infliximab in Patients With Ankylosing Spondylitis.

Aim: The aim of this study was to study the effect of modified maintenance doses (MDs) of infliximab on the quality of life (QoL) of patients with ankylosing spondylitis (AS) over a period of 3 years.

Methods: Medical records of AS patients (n = 25) who received a normal induction dose but modified MDs as required were retrospectively analyzed. After induction dose and the first MD, patients were followed up every month and were treated with infliximab whenever Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score was 4 or greater.

Tuberculosis and Acute Deep Vein Thrombosis in a Paediatric Case.

Deep vein thrombosis (DVT) may be associated with tuberculosis infection. DVT in tuberculosis (TB) is implicated to the release of inflammatory cytokines, decrease synthesis of anti-coagulant proteins and increased fibrinogen levels. Drugs may also predispose to the hyper-coaguability.

Factors affecting outcome of treatment of chronic hepatitis C: result of an open label study from eastern India.

Background: Standard treatment of hepatitis C involves the use of pegylated interferon (PEGIFN) and ribavirin but directly acting antiviral agents (DAA) with seemingly greater efficacy have now appeared on the market. Thus closer detail needs to be given to optimise the use of the former.

Methods: Fifty-two chronic hepatitis C patients (Child class A) were administered PEGIFN and ribavirin in a prospective, open label study in standard dose and duration.

Trends of chronic liver disease in a tertiary care referral hospital in Eastern India.

Background: There is scarce Indian data on time trends of hepatitis, an impediment to formulate an effective public health policy on the matter.

Objective: The aim was to study secular trends and burden of hepatitis in a railway population.

Materials And Methods: Outdoor, indoor, endoscopy unit and mortality records of patients attending this hospital from January 2003 to December 2011 were searched manually and relevant parameters of hepatitis patients were noted, especially etiology, clinical features, treatment, and mortality.

Nimotuzumab plus chemotherapy versus chemotherapy alone in advanced non-small-cell lung cancer: a multicenter, randomized, open-label Phase II study.

Background: The purpose of this study was to evaluate the safety and efficacy of nimotuzumab in combination with chemotherapy (docetaxel and carboplatin) versus chemotherapy alone in patients with stage IIIB/IV non-small-cell lung cancer.

Methods: This multicenter, open-label, Phase II study randomized 110 patients to receive nimotuzumab plus chemotherapy (nimotuzumab group) or chemotherapy alone (control group), and comprised concomitant, maintenance, and follow-up phases. Nimotuzumab 200 mg was administered once weekly for 13 weeks during the first two phases with four cycles of chemotherapy and docetaxel 75 mg/m(2) and carboplatin (area under the curve 5 mg/mL*min) every 3 weeks for a maximum of four cycles during the concomitant phase.

Retrosternal goitre with subclinical hyperthyroidism presenting with trochanteric fracture.

We report a 55-year-old female who presented with trochanteric fracture of right femur. Examination and investigation revealed a huge retrosternal goiter with compression of great vessels which was asymptomatic for more than two decades. Subsequent investigation confirmed it as a case of toxic multinodular goitre with subclinical hyperthyroidism which is the possible cause of secondary osteoporosis and fracture.

Inflammatory bowel disease in India--changing paradigms.

Background: Inflammatory bowel disease is an emerging problem in Asia including India. Clinical data on this disease from eastern India and on its temporal trends in India is scarce.

Materials And Methods: Existing Indian data on inflammatory bowel disease were retrieved using PubMed and a comparison of earlier data (up to 1980s) was made with more recent data (1990s and later) and our own data to find any significant differences.

Fenofibrate-induced myopathy.

Fenofibrate induced myopathy is a rare adverse event. We present a case of muscle pain and quadriparesis following administration of 200mg of fenofibrate for 35 days. Patient gradually improved after stopping the drug.

Acute hepatitis B presenting as Guillain-Barré syndrome.

Guillain-Barré syndrome associated with acute hepatitis B virus infection is rare. We report a 56-year-old man who presented as Guillain-Barré syndrome in the absence of icterus and was subsequently shown to have acute hepatitis B. He improved on conservative therapy.