MINATI CHOUDHURY | All India Institute of Medical Sciences, New Delhi (original) (raw)

Papers by MINATI CHOUDHURY

Research paper thumbnail of Sevoflurane as a sole anaesthetic for thymectomy in myasthenia gravis

Acta Anaesthesiologica Scandinavica, 2000

Research paper thumbnail of Left Atrial Strain: Is it a Paragon, Which We Cardiac Anesthesiologists Misconstrue?

Journal of Perioperative Echocardiography

Research paper thumbnail of Comparison the Effect of Etomidate vs. Thiopentone on Left Ventricular Strain and Strain Rate at the Time of Anesthesia Induction in Patients Undergoing Elective Coronary Artery Bypass Surgery: A Randomized Double Blind Controlled Trial

Journal of Cardiac Critical Care TSS, 2021

Myocardial strain imaging with speckle tracking echocardiography (STE) is getting popularity beca... more Myocardial strain imaging with speckle tracking echocardiography (STE) is getting popularity because it does not depends on insonation angle and has shown good correlation with intraoperative and postoperative ventricular function in patients with coronary artery disease. The impact of thiopentone and etomidate induction on myocardial function was studied and compared on sixty patients undergoing elective coronary artery bypass grafting. Three loops for each views (apical 4 chamber, apical 2 chamber, and apical long axis ) were acquired at base line (T0) and 1 minute (T1) after induction for offline analysis. In Group T, significant increase in HR from the base line values (67.8 ± 13.8 vs 79.2 ± 15.6, p = 0.001) occurred post induction, where as in Group E it remain near to the base line (71.7 ± 8.3 vs 70.1± 8.9, p = 0.345). A reduction in mean arterial pressure (MAP) was noted in both the groups after the injection of the allocated drug. There was no significant difference in the i...

Research paper thumbnail of Cardiac tamponade caused by central venous catheter perforation of the heart : Clinical suspicion can save a patient

Indian Journal of Anaesthesia, 2003

Research paper thumbnail of Recurrent sternal sinuses caused by retained temporary epicardial pacing wires and different wire fixation techniques

Journal of the Practice of Cardiovascular Sciences, 2018

Temporary epicardial pacing wires are routinely used after open-heart surgery without any major c... more Temporary epicardial pacing wires are routinely used after open-heart surgery without any major complications, but varied complications have been described with their use though rare. They are often pulled out after recovery of the patient, usually on the 4th postoperative day, but sometimes, they are cut flush with the skin, especially if they are not coming out after the usual amount of pulling force. We describe a patient who had recurrent sternal sinuses with retained pacing wires which were missed on imaging. We emphasize on the importance of proper fixing of epicardial pacing wires during cardiac surgery, the need for their complete removal after recovery and the need of documenting the same in discharge summaries if they are cut flush and retained in situ.

Research paper thumbnail of Changes in bispectral indesx (Bis) and Near Infrared Pectroscopy (NIRS) During Cardiopulmonary Bypass in Adult Patients Undergoing Coronary Artery Bypass Grafting

The journal of extra-corporeal technology, 2015

Research paper thumbnail of Anaesthetic management of PDA ligation in a child weighing 950 gms

Journal of Anaesthesiology …, 2006

... Chaitali Sen 1 , Usha Kiran 2 , Minati Choudhury 3 , Puneet Goyal 1 1 Senior Resident, Depart... more ... Chaitali Sen 1 , Usha Kiran 2 , Minati Choudhury 3 , Puneet Goyal 1 1 Senior Resident, Department of Cardiac Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India 2 Prof and Head, Department of Cardiac Anaesthesiology, All India Institute of Medical ...

Research paper thumbnail of Hemodynamic monitoring in the intensive care unit

Clinics in Chest Medicine, 2003

Hemodynamic monitoring is a diagnostic tool. Because hemodynamic monitoring often requires invasi... more Hemodynamic monitoring is a diagnostic tool. Because hemodynamic monitoring often requires invasive procedures, it can be associated with an increased incidence of untoward events. Like any diagnostic tool, its ability to improve outcome will be primarily related to the survival benefit enjoyed by specific therapies that can only be given without complications based on their use. Presently, few specific treatment plans fit into this category. The diagnostic accuracy of preload responsiveness is markedly improved by the use of arterial pulse pressure or stroke volume variation, neither of which require pulmonary arterial catheterization. The field of hemodynamic monitoring is rapidly evolving and will probably continue to evolve at this rapid pace over the next 5 to 10 years as new technologies, information management systems, and our understanding of the pathophysiology of critical illness progresses.

Research paper thumbnail of TIVA for ECMO and VAD

Journal of Cardiac Critical Care TSS, 2021

In recent decades, the use of temporary and permanent use of mechanical assist devices is on the ... more In recent decades, the use of temporary and permanent use of mechanical assist devices is on the rise for patients with end-stage cardiac failure. These support strategies hold inherently different risks in the face of noncardiac critical illness and require multidisciplinary treatment strategies. The main issues with all mechanical devices whether extracorporeal membrane oxygenation (ECMO) or ventricular assist device (VAD), are related to thrombosis, anticoagulation, infection, avoiding hypertension and thus use of intravenous drugs, which requires intense monitoring, to circumvent further renal, ischemic or neurological injury and prevent complication.

Research paper thumbnail of Role of Platelet Function Test in Predicting Postoperative Bleeding Risk after Coronary Artery Bypass Grafting: A Prospective Observational Study

Journal of Cardiac Critical Care TSS, 2021

Patients undergoing cardiac surgery are at risk of excessive bleeding and its associated complica... more Patients undergoing cardiac surgery are at risk of excessive bleeding and its associated complications. Excessive bleeding during and after cardiac surgery has an incidence of ~20%. Massive bleeding and subsequent requirement for blood product administration and mediastinal reexploration are associated with significant morbidity and mortality. Postoperative, nonsurgical bleeding in cardiac surgical patients is often multifactorial. Platelet dysfunction, excessive fibrinolysis, hypothermia, preoperative anemia, and deficiency of coagulation factors or their dilution are all suggested etiologies of postoperative bleeding. In the Arachidonic Acid Thromboelastometry (ARATEM) test, platelets are activated with arachidonic acid; in Adenosine diphosphate Thromboelastometry (ADPTEM) test, platelets are activated with adenosine diphosphate; and in TRAPTEM test, platelets are activated with thrombin receptor-activating peptide 6. Measurement time is 6 minutes, and results are expressed in thr...

Research paper thumbnail of Additional file 2 of In vivo assessment of a single adenine mutation in 5′UTR of Endothelin-1 gene in paediatric cases with severe pulmonary hypertension: an observational study

Additional file2: Figure S1. Alignment of promoter region of edn1 gene from patient samples. The ... more Additional file2: Figure S1. Alignment of promoter region of edn1 gene from patient samples. The amplified promoter regions from edn1 gene depicting the conserved promoter elements from 38 patient samples in the cyanotic and acyanotic groups are shown aligned to the reference sequence (NG_016196.1). Figure S2. Sequencing chromatogram of the 5' UTR of the ET-1 gene showing 3A/3A homozygous, 4A/4A homozygous and 3A/4A heterozygous allelic condition with an insertion of adenine (A) at +139 position from the transcription initiation site. Figure S3. Plasma Endothelin-1 (ET-1) levels (pg/ml) in CHD patients. The distribution of ET-1 levels in both Cyanotic and Acyanotic groups is represented for each patient with the median value for each group. [*p-value calculated using non-parametric Mann-Whitney test].

Research paper thumbnail of Anaesthesia Challenges during Sternal Wound Debridement

Journal of Cardiac Critical Care TSS, 2021

A 50-year-old female weighing 80 kg is posted for a deep sternal wound debridement, post mitral v... more A 50-year-old female weighing 80 kg is posted for a deep sternal wound debridement, post mitral valve replacement (MVR), and post-CABG (Coronary Artery Bypass Grafting) (left internal mammary artery (LIMA)→left anterior descending (LAD)). She had sternal osteomyelitis and had wound debridement thrice before. She had also history of cardiac injury repair during second wound debridement.Her initial three tissue cultures showed Acinetobacter positive. Her fourth tissue culture shows Staphylococcus haemolyticus positive. Histopathology shows necrotizing granuloma. Two-dimensional Echocardiography (ECHO) shows post-MVR, no Mitral regurgitation (MR), mild Tricuspid Regurgitation (TR) (right ventricular systolic pressure (RVSP)-24 + Retrograde autologous priming (RAP)), Inferior Vena Cava #x0028;IVC) 1.6 cm with respiratory collapse, no pericardial effusion, no Left atrium (LA) clot/veg, and normal biventricular function.

Research paper thumbnail of Beating heart tricuspid valve replacement without snugging vena cavae

Journal of the Practice of Cardiovascular Sciences, 2018

Tricuspid valve replacement (TVR) is traditionally performed after giving cardioplegia and arrest... more Tricuspid valve replacement (TVR) is traditionally performed after giving cardioplegia and arresting the heart, but sometimes dense adhesions in redo cases can render looping superior and inferior vena cavae almost impossible. We had a case where the right atrium was hugely dilated and stuck and adhesions were dense, and the condition of the patient was too sick to tolerate myocardial ischemia. We did TVR on a beating heart with femoral and innominate vein cannulation without snugging vena cavae and carefully maintaining a blood level in the right atrium just below tricuspid valve and above the vena caval opening so as to avoid an air lock. It is an innovative technique in a difficult scenario.

Research paper thumbnail of Does Baseline Pao2/Fio2 Affect the In-Hospital Outcome in Patients Undergoing Coronary Artery Bypass Grafting?

Journal of clinical trials, 2016

Background: Oxygen saturation and the PaO2 are the direct risk factors for post -operative respir... more Background: Oxygen saturation and the PaO2 are the direct risk factors for post -operative respiratory outcome in patients undergoing prolonged surgery under general anaesthesia. However the effect of preoperative PaO2 and PaO2 /FiO2 ratio on the postoperative course of the patient undergoing coronary artery bypass grafting is not known. Hypothesis: Pre-operative PaO2 and PaO2 /FiO2 ratio have a significant effect on the postoperative outcome among the patients undergoing coronary artery bypass grafting. Study design: Prospective clinical study Setting: Tertiary health care centre Materials and Methods: One hundred and fifty eight consecutive patients with a EURO Score of <6 undergoing routine first time coronary artery bypass grafting were selected for this study. Patients with ventricular dysfunction, Chronic Obstructive Pulmonary Disease (COPD), renal or hepatic dysfunction, patients on mechanical ventilation, on preoperative Intra Aortic Ballon Pump (IABP) and those who had t...

Research paper thumbnail of A comparative study of Albumin versus 6% Hydroxyethyl starch used as priming solution for Cardiopulmonary Bypass in adults undergoing Coronary Artery Bypass Grafting

The journal of extra-corporeal technology, 2014

Research paper thumbnail of Eeffect of Home Environment on Academic Achievement of Secondary School Students- a Study in Lakhimpur District of Assam

In the present investigation an attempt has been made to study the effect of home environment on ... more In the present investigation an attempt has been made to study the effect of home environment on academic achievement of Secondary school students. The sample of the study consisted of 512 students of class-x drawn from provincialized co-educational Secondary schools of Lakhimpur District of Assam. For collection the data survey method was used. The results of the study revealed that there is no significant difference between boys and girls and rural and urban secondary school students in their home environment and there is a relationship between home environment and academic achievement of secondary school students.

Research paper thumbnail of Hemodynamic Monitoring in Intensive Care Unit:Where we are Today?

A significant alteration of attitude towards hemodynamic monitoring in clinical setting happened ... more A significant alteration of attitude towards hemodynamic monitoring in clinical setting happened during the last half of 1970.This occurred as a consequence towards the relative insensitivity and unresponsiveness of clinical methods to diagnose the rapid physiologic changes, especially in the critical care settings. During the 1980s the principles of hemodynamic monitoring allowed the basic physiological measurements to be applied in a consistent and meaningful manner for the management of a cardiovascular aspect of critical illness. The first paradigm shift in the hemodynamic monitoring can be traced back to the development of cardiac catheterization by Werner Forssmann in 19291. The idea of advanced hemodynamic monitoring was developed by HJC Swan, who developed balloon-tipped Swan-Ganz catheter from his observation of motion of sailboats on the Santa-Monica Bay in 19672. For more than 30 years, the pulmonary catheterization method has generally been accepted and is still the clin...

Research paper thumbnail of Your expert knowledge may put them off: Curse of knowledge among anesthesiologists

SUMMARY The curse of knowledge” is a human cognitive bias that may lead to ineffective communicat... more SUMMARY The curse of knowledge” is a human cognitive bias that may lead to ineffective communication and we should acknowledge that we are affected by it. The communication with patient should be simple and clear. Though anesthesia has become safer following better drugs and technology but still we may face patients with grave co-morbidities. Anesthesiologists may not get enough time to communicate with patients, preoperatively, but we should endeavor to collect as much information as possible from a patient using simple rather technical terms. Effective communication may avoid ’curse of knowledge’ and result in improved patient safety. Anesthesiologists should make an effort to spend considerable time in pre-anaesthesia check-up clinics or in ward to communicate with patient who is likely to undergo surgical procedure. Similarly, we should have a candid communication with trainees in anaesthesia so that the events are not taken for guaranteed. This would avoid the curse of knowledg...

Research paper thumbnail of Inadvertent Right Ventricle Perforation by Temporary Pacemaker Lead: A Case Report Requiring Surgical Exploration

Right ventricle perforation by pacemaker lead is rare but a life-threatening complication. It may... more Right ventricle perforation by pacemaker lead is rare but a life-threatening complication. It may present acutely within few hours of pacemaker implantation as hemopericardium, dreaded cardiac tamponade, leading to acute hemodynamic deterioration; even death, if not address immediately. At times, it presents gradually with progressive decline in hemodynamic and requires surgical exploration.The authors report a case of 51-year old female whose hemodynamic worsens gradually after temporary pacemaker implantation, requiring surgical exploration.

Research paper thumbnail of In vivo assessment of a single adenine mutation in 5′UTR of Endothelin-1 gene in paediatric cases with severe pulmonary hypertension: an observational study

BMC Research Notes, 2021

Objective Endothelin-1 plays an important role in the pathogenesis of severe pulmonary hypertensi... more Objective Endothelin-1 plays an important role in the pathogenesis of severe pulmonary hypertension. The + 139 ‘A’, adenine insertion variant in 5′UTR of edn1 gene has been reported to be associated with increased expression of Endothelin-1 in vitro. The aim of present study was to explore the association of this variant with the circulating levels of Endothelin-1 in vivo using archived DNA and plasma samples from 38 paediatric congenital heart disease (cyanotic and acyanotic) patients with severe pulmonary hypertension. Results The plasma Endothelin-1 levels were highly varied ranging from 1.63 to75.16 pg/ml. The + 139 ‘A’ insertion variant in 5′UTR of edn1 was seen in 8 out of 38 cases with only one acyanotic sample demonstrating homozygosity of inserted ‘A’ allele at + 139 site (4A/4A genotype). The plasma Endothelin-1 levels in children with homozygous variant 3A/3A genotype were comparable in cyanotic and acyanotic groups. Lone 4A/4A acyanotic sample had ET-1 levels similar to ...

Research paper thumbnail of Sevoflurane as a sole anaesthetic for thymectomy in myasthenia gravis

Acta Anaesthesiologica Scandinavica, 2000

Research paper thumbnail of Left Atrial Strain: Is it a Paragon, Which We Cardiac Anesthesiologists Misconstrue?

Journal of Perioperative Echocardiography

Research paper thumbnail of Comparison the Effect of Etomidate vs. Thiopentone on Left Ventricular Strain and Strain Rate at the Time of Anesthesia Induction in Patients Undergoing Elective Coronary Artery Bypass Surgery: A Randomized Double Blind Controlled Trial

Journal of Cardiac Critical Care TSS, 2021

Myocardial strain imaging with speckle tracking echocardiography (STE) is getting popularity beca... more Myocardial strain imaging with speckle tracking echocardiography (STE) is getting popularity because it does not depends on insonation angle and has shown good correlation with intraoperative and postoperative ventricular function in patients with coronary artery disease. The impact of thiopentone and etomidate induction on myocardial function was studied and compared on sixty patients undergoing elective coronary artery bypass grafting. Three loops for each views (apical 4 chamber, apical 2 chamber, and apical long axis ) were acquired at base line (T0) and 1 minute (T1) after induction for offline analysis. In Group T, significant increase in HR from the base line values (67.8 ± 13.8 vs 79.2 ± 15.6, p = 0.001) occurred post induction, where as in Group E it remain near to the base line (71.7 ± 8.3 vs 70.1± 8.9, p = 0.345). A reduction in mean arterial pressure (MAP) was noted in both the groups after the injection of the allocated drug. There was no significant difference in the i...

Research paper thumbnail of Cardiac tamponade caused by central venous catheter perforation of the heart : Clinical suspicion can save a patient

Indian Journal of Anaesthesia, 2003

Research paper thumbnail of Recurrent sternal sinuses caused by retained temporary epicardial pacing wires and different wire fixation techniques

Journal of the Practice of Cardiovascular Sciences, 2018

Temporary epicardial pacing wires are routinely used after open-heart surgery without any major c... more Temporary epicardial pacing wires are routinely used after open-heart surgery without any major complications, but varied complications have been described with their use though rare. They are often pulled out after recovery of the patient, usually on the 4th postoperative day, but sometimes, they are cut flush with the skin, especially if they are not coming out after the usual amount of pulling force. We describe a patient who had recurrent sternal sinuses with retained pacing wires which were missed on imaging. We emphasize on the importance of proper fixing of epicardial pacing wires during cardiac surgery, the need for their complete removal after recovery and the need of documenting the same in discharge summaries if they are cut flush and retained in situ.

Research paper thumbnail of Changes in bispectral indesx (Bis) and Near Infrared Pectroscopy (NIRS) During Cardiopulmonary Bypass in Adult Patients Undergoing Coronary Artery Bypass Grafting

The journal of extra-corporeal technology, 2015

Research paper thumbnail of Anaesthetic management of PDA ligation in a child weighing 950 gms

Journal of Anaesthesiology …, 2006

... Chaitali Sen 1 , Usha Kiran 2 , Minati Choudhury 3 , Puneet Goyal 1 1 Senior Resident, Depart... more ... Chaitali Sen 1 , Usha Kiran 2 , Minati Choudhury 3 , Puneet Goyal 1 1 Senior Resident, Department of Cardiac Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India 2 Prof and Head, Department of Cardiac Anaesthesiology, All India Institute of Medical ...

Research paper thumbnail of Hemodynamic monitoring in the intensive care unit

Clinics in Chest Medicine, 2003

Hemodynamic monitoring is a diagnostic tool. Because hemodynamic monitoring often requires invasi... more Hemodynamic monitoring is a diagnostic tool. Because hemodynamic monitoring often requires invasive procedures, it can be associated with an increased incidence of untoward events. Like any diagnostic tool, its ability to improve outcome will be primarily related to the survival benefit enjoyed by specific therapies that can only be given without complications based on their use. Presently, few specific treatment plans fit into this category. The diagnostic accuracy of preload responsiveness is markedly improved by the use of arterial pulse pressure or stroke volume variation, neither of which require pulmonary arterial catheterization. The field of hemodynamic monitoring is rapidly evolving and will probably continue to evolve at this rapid pace over the next 5 to 10 years as new technologies, information management systems, and our understanding of the pathophysiology of critical illness progresses.

Research paper thumbnail of TIVA for ECMO and VAD

Journal of Cardiac Critical Care TSS, 2021

In recent decades, the use of temporary and permanent use of mechanical assist devices is on the ... more In recent decades, the use of temporary and permanent use of mechanical assist devices is on the rise for patients with end-stage cardiac failure. These support strategies hold inherently different risks in the face of noncardiac critical illness and require multidisciplinary treatment strategies. The main issues with all mechanical devices whether extracorporeal membrane oxygenation (ECMO) or ventricular assist device (VAD), are related to thrombosis, anticoagulation, infection, avoiding hypertension and thus use of intravenous drugs, which requires intense monitoring, to circumvent further renal, ischemic or neurological injury and prevent complication.

Research paper thumbnail of Role of Platelet Function Test in Predicting Postoperative Bleeding Risk after Coronary Artery Bypass Grafting: A Prospective Observational Study

Journal of Cardiac Critical Care TSS, 2021

Patients undergoing cardiac surgery are at risk of excessive bleeding and its associated complica... more Patients undergoing cardiac surgery are at risk of excessive bleeding and its associated complications. Excessive bleeding during and after cardiac surgery has an incidence of ~20%. Massive bleeding and subsequent requirement for blood product administration and mediastinal reexploration are associated with significant morbidity and mortality. Postoperative, nonsurgical bleeding in cardiac surgical patients is often multifactorial. Platelet dysfunction, excessive fibrinolysis, hypothermia, preoperative anemia, and deficiency of coagulation factors or their dilution are all suggested etiologies of postoperative bleeding. In the Arachidonic Acid Thromboelastometry (ARATEM) test, platelets are activated with arachidonic acid; in Adenosine diphosphate Thromboelastometry (ADPTEM) test, platelets are activated with adenosine diphosphate; and in TRAPTEM test, platelets are activated with thrombin receptor-activating peptide 6. Measurement time is 6 minutes, and results are expressed in thr...

Research paper thumbnail of Additional file 2 of In vivo assessment of a single adenine mutation in 5′UTR of Endothelin-1 gene in paediatric cases with severe pulmonary hypertension: an observational study

Additional file2: Figure S1. Alignment of promoter region of edn1 gene from patient samples. The ... more Additional file2: Figure S1. Alignment of promoter region of edn1 gene from patient samples. The amplified promoter regions from edn1 gene depicting the conserved promoter elements from 38 patient samples in the cyanotic and acyanotic groups are shown aligned to the reference sequence (NG_016196.1). Figure S2. Sequencing chromatogram of the 5' UTR of the ET-1 gene showing 3A/3A homozygous, 4A/4A homozygous and 3A/4A heterozygous allelic condition with an insertion of adenine (A) at +139 position from the transcription initiation site. Figure S3. Plasma Endothelin-1 (ET-1) levels (pg/ml) in CHD patients. The distribution of ET-1 levels in both Cyanotic and Acyanotic groups is represented for each patient with the median value for each group. [*p-value calculated using non-parametric Mann-Whitney test].

Research paper thumbnail of Anaesthesia Challenges during Sternal Wound Debridement

Journal of Cardiac Critical Care TSS, 2021

A 50-year-old female weighing 80 kg is posted for a deep sternal wound debridement, post mitral v... more A 50-year-old female weighing 80 kg is posted for a deep sternal wound debridement, post mitral valve replacement (MVR), and post-CABG (Coronary Artery Bypass Grafting) (left internal mammary artery (LIMA)→left anterior descending (LAD)). She had sternal osteomyelitis and had wound debridement thrice before. She had also history of cardiac injury repair during second wound debridement.Her initial three tissue cultures showed Acinetobacter positive. Her fourth tissue culture shows Staphylococcus haemolyticus positive. Histopathology shows necrotizing granuloma. Two-dimensional Echocardiography (ECHO) shows post-MVR, no Mitral regurgitation (MR), mild Tricuspid Regurgitation (TR) (right ventricular systolic pressure (RVSP)-24 + Retrograde autologous priming (RAP)), Inferior Vena Cava #x0028;IVC) 1.6 cm with respiratory collapse, no pericardial effusion, no Left atrium (LA) clot/veg, and normal biventricular function.

Research paper thumbnail of Beating heart tricuspid valve replacement without snugging vena cavae

Journal of the Practice of Cardiovascular Sciences, 2018

Tricuspid valve replacement (TVR) is traditionally performed after giving cardioplegia and arrest... more Tricuspid valve replacement (TVR) is traditionally performed after giving cardioplegia and arresting the heart, but sometimes dense adhesions in redo cases can render looping superior and inferior vena cavae almost impossible. We had a case where the right atrium was hugely dilated and stuck and adhesions were dense, and the condition of the patient was too sick to tolerate myocardial ischemia. We did TVR on a beating heart with femoral and innominate vein cannulation without snugging vena cavae and carefully maintaining a blood level in the right atrium just below tricuspid valve and above the vena caval opening so as to avoid an air lock. It is an innovative technique in a difficult scenario.

Research paper thumbnail of Does Baseline Pao2/Fio2 Affect the In-Hospital Outcome in Patients Undergoing Coronary Artery Bypass Grafting?

Journal of clinical trials, 2016

Background: Oxygen saturation and the PaO2 are the direct risk factors for post -operative respir... more Background: Oxygen saturation and the PaO2 are the direct risk factors for post -operative respiratory outcome in patients undergoing prolonged surgery under general anaesthesia. However the effect of preoperative PaO2 and PaO2 /FiO2 ratio on the postoperative course of the patient undergoing coronary artery bypass grafting is not known. Hypothesis: Pre-operative PaO2 and PaO2 /FiO2 ratio have a significant effect on the postoperative outcome among the patients undergoing coronary artery bypass grafting. Study design: Prospective clinical study Setting: Tertiary health care centre Materials and Methods: One hundred and fifty eight consecutive patients with a EURO Score of <6 undergoing routine first time coronary artery bypass grafting were selected for this study. Patients with ventricular dysfunction, Chronic Obstructive Pulmonary Disease (COPD), renal or hepatic dysfunction, patients on mechanical ventilation, on preoperative Intra Aortic Ballon Pump (IABP) and those who had t...

Research paper thumbnail of A comparative study of Albumin versus 6% Hydroxyethyl starch used as priming solution for Cardiopulmonary Bypass in adults undergoing Coronary Artery Bypass Grafting

The journal of extra-corporeal technology, 2014

Research paper thumbnail of Eeffect of Home Environment on Academic Achievement of Secondary School Students- a Study in Lakhimpur District of Assam

In the present investigation an attempt has been made to study the effect of home environment on ... more In the present investigation an attempt has been made to study the effect of home environment on academic achievement of Secondary school students. The sample of the study consisted of 512 students of class-x drawn from provincialized co-educational Secondary schools of Lakhimpur District of Assam. For collection the data survey method was used. The results of the study revealed that there is no significant difference between boys and girls and rural and urban secondary school students in their home environment and there is a relationship between home environment and academic achievement of secondary school students.

Research paper thumbnail of Hemodynamic Monitoring in Intensive Care Unit:Where we are Today?

A significant alteration of attitude towards hemodynamic monitoring in clinical setting happened ... more A significant alteration of attitude towards hemodynamic monitoring in clinical setting happened during the last half of 1970.This occurred as a consequence towards the relative insensitivity and unresponsiveness of clinical methods to diagnose the rapid physiologic changes, especially in the critical care settings. During the 1980s the principles of hemodynamic monitoring allowed the basic physiological measurements to be applied in a consistent and meaningful manner for the management of a cardiovascular aspect of critical illness. The first paradigm shift in the hemodynamic monitoring can be traced back to the development of cardiac catheterization by Werner Forssmann in 19291. The idea of advanced hemodynamic monitoring was developed by HJC Swan, who developed balloon-tipped Swan-Ganz catheter from his observation of motion of sailboats on the Santa-Monica Bay in 19672. For more than 30 years, the pulmonary catheterization method has generally been accepted and is still the clin...

Research paper thumbnail of Your expert knowledge may put them off: Curse of knowledge among anesthesiologists

SUMMARY The curse of knowledge” is a human cognitive bias that may lead to ineffective communicat... more SUMMARY The curse of knowledge” is a human cognitive bias that may lead to ineffective communication and we should acknowledge that we are affected by it. The communication with patient should be simple and clear. Though anesthesia has become safer following better drugs and technology but still we may face patients with grave co-morbidities. Anesthesiologists may not get enough time to communicate with patients, preoperatively, but we should endeavor to collect as much information as possible from a patient using simple rather technical terms. Effective communication may avoid ’curse of knowledge’ and result in improved patient safety. Anesthesiologists should make an effort to spend considerable time in pre-anaesthesia check-up clinics or in ward to communicate with patient who is likely to undergo surgical procedure. Similarly, we should have a candid communication with trainees in anaesthesia so that the events are not taken for guaranteed. This would avoid the curse of knowledg...

Research paper thumbnail of Inadvertent Right Ventricle Perforation by Temporary Pacemaker Lead: A Case Report Requiring Surgical Exploration

Right ventricle perforation by pacemaker lead is rare but a life-threatening complication. It may... more Right ventricle perforation by pacemaker lead is rare but a life-threatening complication. It may present acutely within few hours of pacemaker implantation as hemopericardium, dreaded cardiac tamponade, leading to acute hemodynamic deterioration; even death, if not address immediately. At times, it presents gradually with progressive decline in hemodynamic and requires surgical exploration.The authors report a case of 51-year old female whose hemodynamic worsens gradually after temporary pacemaker implantation, requiring surgical exploration.

Research paper thumbnail of In vivo assessment of a single adenine mutation in 5′UTR of Endothelin-1 gene in paediatric cases with severe pulmonary hypertension: an observational study

BMC Research Notes, 2021

Objective Endothelin-1 plays an important role in the pathogenesis of severe pulmonary hypertensi... more Objective Endothelin-1 plays an important role in the pathogenesis of severe pulmonary hypertension. The + 139 ‘A’, adenine insertion variant in 5′UTR of edn1 gene has been reported to be associated with increased expression of Endothelin-1 in vitro. The aim of present study was to explore the association of this variant with the circulating levels of Endothelin-1 in vivo using archived DNA and plasma samples from 38 paediatric congenital heart disease (cyanotic and acyanotic) patients with severe pulmonary hypertension. Results The plasma Endothelin-1 levels were highly varied ranging from 1.63 to75.16 pg/ml. The + 139 ‘A’ insertion variant in 5′UTR of edn1 was seen in 8 out of 38 cases with only one acyanotic sample demonstrating homozygosity of inserted ‘A’ allele at + 139 site (4A/4A genotype). The plasma Endothelin-1 levels in children with homozygous variant 3A/3A genotype were comparable in cyanotic and acyanotic groups. Lone 4A/4A acyanotic sample had ET-1 levels similar to ...

Research paper thumbnail of CME Book ICACON 2016

This book contains the write up of few of the topics presented in Indian College of Anaesthesiolo... more This book contains the write up of few of the topics presented in Indian College of Anaesthesiologists national conference (ICACON) 2016 held in Shillong, India.