Deepanshu Dhiman - Academia.edu (original) (raw)

Papers by Deepanshu Dhiman

Pain Practice, Sep 18, 2023

Indian journal of clinical medicine, Apr 3, 2024

Indian Heart Journal, 2015

Introduction: Delayed contrast enhanced Cardiac MRI has been accepted as a standard tool worldwid... more Introduction: Delayed contrast enhanced Cardiac MRI has been accepted as a standard tool worldwide for determination of infarcted myocardium and viability. Infarct size as determined by cardiac MRI has important therapeutic and prognostic information. Methods: Twenty six STEMI patients who had received thrombolytic therapy were subjected to cardiac MRI assessment at 5e7 day of admission. Base line variables of the study population were compared with the acute infarct size as determined by the Cardiac MRI. Results: The mean acute infarct size in our study population was 27.2 ± 17.4% of LV. We found through univariate analysis that final infarct size was dependent on time to thrombolysis (p ¼ 0.04), Status of Thrombolysis (p ¼ 0.01), smoking status (p ¼ 0.02), location of infarct (p < 0.00001), presence of microvascular obstruction (p ¼ 0.01) and viability status (p ¼ 0.0004). Thus, larger acute infarct size was seen in delayed time to thrombolysis, failed status of thrombolysis, smokers, anterior location of the infarct, presence of microvascular obstruction and non viable myocardial status. Conclusion: Infarct size as determined by Cardiac MRI has been shown to carry important therapeutic and prognostic information. We have tried to evaluate predictors of acute infarct on cardiac MRI in STEMI patients during their initial hospital stay. Knowing the predictors of acute infarct size can help in early intervention and provide prognostic information for future cardiac events.

This is a controlled randomized trial which evaluated the clinical and molecular changes resultin... more This is a controlled randomized trial which evaluated the clinical and molecular changes resulting from Integrated approach of yoga therapy (IAYT) as an adjunct regimen and compared it with usual care for the management of chronic low back pain patients. We enrolled 29 adult patients with chronic low back pain (CLBP). Patients were randomly divided into two groups. Control group received the usual care of treatment as per institutional protocol. The yoga group received IAYT as an adjunct to usual care. Primary outcomes were pain Intensity assessed by verbal numerical rating scale (VNRS) and functional ability assessed by Modified Oswestry Disability Index (MODI). Secondary outcomes were pain catastrophizing, quality of life, fear of movement related to CLBP, type of pain, levels of ß-Endorphin and TNF α and Salivary CGRP. All parameters were measured at baseline, one month, and three months. Significant decrease in VNRS score at 1 and 3 months was observed in both the groups with ...

Ain-Shams Journal of Anesthesiology

Background A patient with chronic kidney disease and recurrent catheter-related thrombosis. Case ... more Background A patient with chronic kidney disease and recurrent catheter-related thrombosis. Case presentation The patient had femoral vein thrombosis and was scheduled for laparoscopically assisted continuous ambulatory peritoneal dialysis catheter insertion. The chief concerns during the perioperative period were the risk of pulmonary thromboembolism, limited venous access, and risk of bleeding as the patient was on anticoagulation therapy. Meticulous attention was paid to history, clinical examination, and to the ongoing treatment with regard to risk of systemic thrombosis. Conclusions Management was tailored according to risk of thrombosis and bleeding during perioperative period along with identification adverse events associated with anticoagulation and preparedness for management of pulmonary embolism.

Indian Journal of Anaesthesia

Patient 1 A 45-year-old female reported continuous, moderate-to-severe pain in auricular, tempora... more Patient 1 A 45-year-old female reported continuous, moderate-to-severe pain in auricular, temporal, mandibular and upper neck areas for 2 years. The visual analog score (VAS) was 7 to 8 and pain aggravated on chewing solid foods. She obtained multiple consultations and received intraoral blocks for pain, but pain relief was suboptimal. There were no neurological symptoms in the upper limbs. Musculoskeletal pain, facet joint involvement, glossopharyngeal neuralgia, trigeminal neuralgia and cervical spondylosis were considered as differential diagnoses and evaluated. The blood investigations were normal, and neck radiograph revealed bilateral prominent styloid processes (20 mm). A cervical spine radiograph revealed reduced C5–C6 intervertebral disc space with multiple osteophytes. Magnetic resonance imaging (MRI) neck reported cervical spondylosis with diffuse circumferential disc bulge at C5–C6 and C6–C7 levels without canal stenosis. Based on symptomatology, a diagnostic left side glossopharyngeal nerve block was performed but did not provide pain relief. Mandibular nerve blocks provided for mandibular pain at two different settings also could not provide adequate pain relief. Consequently, a clinical diagnosis of cervical spondylosis with somatically referred anterior neck and facial pain from cervical spine tissue was made considering magnetic resonance imaging (MRI) findings and the territorial distribution of pain. An ultrasound-guided (USG) superficial cervical plexus (SCP) block with 7.0 ml of 0.2% ropivacaine and 40 mg triamcinolone was performed. This resulted in resolution of pain (VAS of 2) from all the painful areas. During follow-up of 1 year, patient reported a VAS score of 0. The World Health Organization quality of life-BREF (WHOQOL-BREF) raw score[2] improved from 45 to 117.

Journal of Human Reproductive Sciences, 2020

Multiple endocrine neoplasia (MEN) syndrome has rarely been reported during pregnancy. The multip... more Multiple endocrine neoplasia (MEN) syndrome has rarely been reported during pregnancy. The multiple manifestations of the syndrome along with the normal body changes associated with pregnancy can prove to be difficult to manage. We describe our experience of the diagnosis and management of MEN1 syndrome in a pregnant female.

Anesthesia: Essays and Researches, 2019

Point-of-care ultrasonography is defined as ultrasonography brought to the patient's bedside ... more Point-of-care ultrasonography is defined as ultrasonography brought to the patient's bedside and performed by the provider in real time. The clinician can use these real-time dynamic images immediately (rather than images recorded by a sonographer and interpreted later), allowing findings to be directly correlated with the patient's presenting signs and symptoms. Point-of-care ultrasonography is easily repeatable if the patient's condition changes. Over the past decade, the use of point-of-care ultrasonography has extended to emergency settings and intensive care units. The role of ultrasound in triage patients is not only limited to the Focused Assessment with Sonography for Trauma which includes assessment for hemoperitoneum and hemopericardium, it has also been used to detect the presence of hemothorax, pneumothorax, and intravascular filling status in a trauma patient. However, the use of ultrasonography in detecting pulmonary thromboembolism in trauma has not been commonly reported. We report a patient in whom submassive pulmonary embolism was detected by lung ultrasound and thereafter operated for bilateral open Grade III lower-limb fractures. The surgery was proceeded under bilateral ultrasound-guided femoral sciatic nerve block.

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2019

A 65-year-old male diagnosed with carcinoma head of pancreas, post-chemotherapy was posted for Wh... more A 65-year-old male diagnosed with carcinoma head of pancreas, post-chemotherapy was posted for Whipple's procedure. All baseline investigations before the procedure were normal. The anaesthetic plan for the procedure was general anaesthesia with invasive pressure monitoring. CVC line and arterial cannula placement were planned for invasive pressure monitoring and post-operative administration of fluids and drugs. After intravenous induction, the right side IJV was cannulated by a trainee resident under USG guidance, in the presence of an anaesthesia consultant. The seven French triple lumen CVC was placed by Seldinger's technique, free flow was confirmed in all the three ports and CVC was fixed at 12 cm.

Indian Journal of Critical Care Medicine, 2018

Sir, Central venous cannulation (CVC) is a commonly performed procedure in emergency, critical ca... more Sir, Central venous cannulation (CVC) is a commonly performed procedure in emergency, critical care and perioperative period. The use of ultrasound (US) guidance for CVC increases the overall success rate of cannulation by 71% compared to the landmark technique. [1]

British Journal of Pain, 2017

Background: Recent literature has established the role of stellate ganglion block (SGB) for manag... more Background: Recent literature has established the role of stellate ganglion block (SGB) for management of acute postoperative pain. The effects of dexmedetomidine as an adjuvant to lignocaine in a preoperative SGB for postoperative pain relief have not been evaluated so far. Methods: The following randomised, double-blinded, control trail included 54 patients scheduled for upper limb orthopaedic surgery under general anaesthesia. Preoperative ultrasound-guided (USG) SGB was performed in all patients. Group I (n = 18) received 3.5 mL of a solution (3 mL 2% lignocaine + 0.5 μg/ kg dexmedetomidine for SGB) and 15 mL of intravenous (IV) normal saline (NS). Group II (n = 18) received 3.5 mL of a solution (3 mL 2% lignocaine + 0.5 mL NS for SGB) and 15 mL of IV NS. Group III (n = 18) received 3.5 mL of a solution (3 mL 2% lignocaine + 0.5 mL of NS for SGB) and 0.5 μg/kg dexmedetomidine in 15 mL of IV NS. Postoperatively tramadol consumption and Visual Analogue Scale (VAS) score were recorded up to 48 hours. Results: The cumulative tramadol consumption at the end of 48 hours (p = 0.01) was significantly reduced in the group I as compared to group II. In group I, postoperative VAS at rest was significantly reduced up to 12 hours postoperatively as compared to group II (p = 0.05). The cumulative tramadol consumption was not reduced significantly in group III compared to group II (p = 0.51). Conclusion: Dexmedetomidine as an adjuvant to SGB along with lignocaine produced a significant tramadol sparing effect and superior analgesia as compared to IV dexmedetomidine and control group. 1

Acta Anaesthesiologica Scandinavica, 2016

Intermittent boluses for neural blockade provide better post‐operative analgesia when compared to... more Intermittent boluses for neural blockade provide better post‐operative analgesia when compared to continuous infusion. However, these techniques of administration have not yet been compared while performing adductor canal block (ACB). We compared intermittent vs. continuous ACB for managing post‐operative pain following anterior cruciate ligament (ACL) reconstruction. The primary endpoint was total morphine consumption for 24 h post‐operatively in both the groups. Secondary outcomes included evaluation of pain scores and opioid‐related side effects.

Indian Journal of Anaesthesia, 2016

$Research paper thumbnail of Extended duration pulsed radiofrequency for the management of refractory meralgia paresthetica: a series of five cases$

The Korean Journal of Pain, 2018

Meralgia paresthetica (MP) is a sensory mononeuropathy, caused by compression of the lateral femo... more Meralgia paresthetica (MP) is a sensory mononeuropathy, caused by compression of the lateral femoral cutaneous nerve (LFCN) of thigh. Patients refractory to conservative management are treated with various interventional procedures. We report the first use of extended duration (8 minutes) pulsed radiofrequency of the LFCN in a case series of five patients with refractory MP. Four patients had follow up for 1-2 years, and one had 6 months follow up. All patients reported remarkable and long lasting symptom relief and an increase in daily life activities. Three patients came off medications and two patients required minimal doses of neuropathic medications. No complications were observed.

International Journal Of Community Medicine And Public Health, 2021

Background: Since the onset of COVID-19 pandemic the elderly population has started experiencing ... more Background: Since the onset of COVID-19 pandemic the elderly population has started experiencing higher levels of anxiety both because of fear of contracting infection and due to restricted social life. Study was done to assess impact of lockdown on mental health of elderly.Methods: This was a retrospective and observational study. 106 participants were enrolled aged above 60 years. A Google survey form was sent to the participants for filling, accompanied by sessions with a clinical psychologist. The socio-demographic data and various psychological parameters were assessed.Results: Depression was most commonly reported (39.6%). Global satisfaction had a significant and positive correlation with both social security index (p=0.004) and social network scale (p=0.000).Conclusions: The prevalence of anxiety, stress and depression increased during lockdown. Overall satisfaction with life was reduced. Psychological counselling and support should be readily available to elderly. The probl...

Saudi Journal of Anaesthesia, 2016

Background: Unintentional intraneural injection under ultrasound guidance (USG) with fine caliber... more Background: Unintentional intraneural injection under ultrasound guidance (USG) with fine caliber needles and lower success rate with large caliber Tuohy needles in supraclavicular brachial plexus block (SCB) have been reported. Materials and Methods: We undertook study to standardize the use of 20-gauge short versus blunt bevel needle for SCB. After approval of Institutional Ethics Committee and written informed consent, patients were randomized using computer-generated random number table to either of the two groups; blunt bevel needle group (n = 30): SCB under USG using 20-gauge Tuohy needle or short bevel needle group (n = 30): SCB under USG using 20-gauge short bevel needle. The primary outcome of the study was time to establishment of sensory and motor block of individual nerves, and secondary outcome was tolerability and any adverse effects. Results: The time to establishment of sensory and motor block in individual nerve territory was similar in both the groups. The complete sensory and motor anesthesia was achieved in 78.3% patients and complete sensory and motor anesthesia after supplementary block was achieved in 86.6% patients. Paresthesias during SCB were recorded in 15 patients. Out of these eight patients were of blunt bevel group and seven patients were of short bevel group. None of the patients experienced any neurological adverse effects. Conclusion: The establishment of sensory and motor blockade of individual nerves was similar to 20-gauge short and blunt bevel needle under ultrasound guide with no neurological adverse events.

Ain-Shams Journal of Anesthesiology, 2022