Posts

OVERCOMING A MAJOR CHALLENGE

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A 53 year old lady presented at Ruby General Hospital with complaints of right flank pain for about a year. She had been put under the expert care of Dr. Sujoy Basak (Consultant Urologist). After a thorough evaluation, an USG revealed a 43 mm calculi (Stone, usually composed of mineral salts) in the pelvis of right kidney and mild Hydronephrosis (Swollen and stretched kidney due to a build-up of urine inside them) in left kidney. The digital X – ray of KUB revealed a large staghorn calculus (A type of kidney stone with branches that takes up a large portion of the urinary collecting area) and another small sized calculi in right kidney. Our 128 slice CE CT scan of KUB also confirmed the calculus measuring 4.5 cm X 3 cm, presence of stone within the ureters with mild proximal hydroureteronephrosis (Dilation of the ureter due to obstruction of urine outflow). The calculus in the left middle ureter at L5 level measured 1.4 cm. The lady was a known patient of hypothyroidism along with...

AFTER DARKNESS COMES LIGHT

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  A 40 year old lady had been presented in the Emergency department of Ruby GeneralHospital with complaints of preterm premature rupture of membranes for last 7 days at 27 weeks of pregnancy. The lady had been admitted under the care of Dr. Ayan Mukhopadhyay ( Consultant Obstetrics & Gynaecologist ) and Dr. Aparupa Ghosh (Consultant Obstetrics & Gynaecologist) and after relevant investigation, the USG report revealed nil liquor. The consultants were faced with multiple challenges, on one hand there was a possibility of chorioamnionitis (A serious condition in pregnancy when the membranes that surround the foetus and the amniotic fluid are infected by bacteria), extreme prematurity along with nil liquor and on the other hand there were every chances of foetal respiratory distress due to immature lungs. The problems became manifold when the patient’s blood sugar reported as high as 370 mg/dl, thus, increasing the chances of an already ongoing chorioamnionitis. After a detail...

BOUNDARIES FADE WHEN IT COMES TO SAVING LIVES

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  An 80-year-old male from Bhutan presented with a right anterior thigh mass. An excisional biopsy revealed myxofibrosarcoma (A type of soft tissue sarcoma which starts as a small lump in the connective tissue), a relatively rare cancer. He underwent excision of the lesion in Bhutan and the tumour was 1.7 cm  X  1.1 cm with margin involvement. The final biopsy report was confirmatory for the same. The gentleman was referred to Ruby Cancer Centre, a unit of Ruby General Hospital in Kolkata for further treatment. Proper metastatic work–up started. He was put on adjuvant radiation under the guidance of Oncology Unit 1, Dr. Sanjoy Roy and Dr. Sandip Sarkar. It reduces the risk of cancer coming back after the primary treatment, eg. surgeries like microscopic bits of cancer sometimes remain undetectable post-removal of all visible cancer. The gentleman has completed 25 fractions of radiation without any complications and had tolerated the treatment perfectly well. Ruby General...

A RARE TYPE OF INTERNAL HERNIA - GIANT PARAESOPHAGEAL HIATUS HERNIA

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  A 65-year-old lady had presented with complaints of chronic cough, chest pain, and discomfort associated with food regurgitation for a few years. She had a history of hypertension and hypothyroidism. After receiving treatment for some time, the symptoms kept recurring and she consulted Dr. Sumanta Dey (Advanced Laparoscopic, Bariatric and GI Surgeon) at Ruby General Hospital . After a thorough evaluation, relevant investigations were advised which revealed a giant Paraesophageal Hiatus Hernia (Type – III). A giant Paraesophageal Hiatus Hernia (Type – III) is a rare type of internal hernia where the esophagus (food pipe) along with the stomach slides into the chest causing compression over the lungs and heart. Thus, the patient usually presents with chest pain, breathing distress, dry cough, food regurgitation and bloating sensation. Sometimes, the blood supply of the stomach gets blocked and causes severe abdominal pain due to strangulated hernia which is a life-threatening sit...

REMOVAL OF A TUMOUR WEIGHING ABOVE 8 KGS

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  A 65-year-old lady had hepresented at Ruby General Hospital with complaints of fullness in r abdomen and was admitted under the Care of (Prof) Dr. Sudhir Adhikari (Consultant Gynaecologist). The lady had been a known case of Hypothyroid for more than one and half decades. A thorough evaluation and relevant investigations revealed a huge mass in the abdomen. After discussion with the family members and with written and informed consent, the lady had been posted for surgery. Laparotomy (Open surgery of the abdomen to examine the abdominal organs) had been performed followed by Total Hysterectomy,   Bilateral Salpingo-Oophorectomy (BSO) (Removal of both ovaries and fallopian tubes) with vault fixation (A surgery to repair vaginal vault prolapse). On opening the abdomen a huge mass approximately 20 cms in diameter had been removed along with 6 litres of fluid. The mass weighed more than 8 kgs. The post-operative period had been uneventful and the lady went home with a lighter ...

THE GOLDEN HOUR DURING CARDIAC EMERGENCY SAVES LIVES

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  A 35 year old gentleman who sells fish on the bicycle in different areas had been presented in the Emergency department of Ruby General Hospital with complaints of severe chest pain and profuse sweating. He was admitted under the expert care of Dr. Tanmoy Majee (Consultant Cardiologist) and after a thorough evaluation and relevant investigations the ECG revealed Acute Anterior Wall Myocardial Infarction (AWMI) and Trop - T (Troponin) test had been positive. Though there were no family members of the gentleman present in the hospital, but, that did not hinder in the treatment to save his life. He had been scheduled for Coronary Angiography which revealed Single Vessel Coronary Artery Disease (A condition in which the walls of the small arteries in the heart do not work properly). This was followed by Percutaneous Translumial Coronary Angioplasty (PTCA) (A procedure that opens blocked coronary arteries to improve the blood flow to the heart muscle.) with stenting (Placing an expa...

A TWIN CHALLENGE

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  A 35 year old lady had been presented at Ruby General Hospital with complaints of pain abdomen, pre-eclamsia (A dangerous pregnancy complication characterized by high blood pressure) induced by her twin pregnancy and had been admitted under the expert care of Dr. Ayan Mukhopadhyay ( Consultant Gynaecologist ). This required careful management, timely investigations and faith in the caregivers. The lady with RH negative, Gestational Diabetes Mellitus (GDM), pre-eclampsia, fatigue and abdominal cramps had been potentially life threatening complications and delivery of her twins were a nightmarish challenge. After detailed discussion with the family members and with informed and written consent the lady had been posted for caesarean section. During surgery the lady had severe complications and adhesions (Band of scar tissues that joins two surfaces of the body that are usually separate) made the abdominal route delivery of the twins a Herculean task for the surgeon. However, the ba...