Biomedical subjects
Publications and source records attributed to Alok Ranjan.
Desmoplastic fibroma is a benign but locally aggressive tumor arising usually from the mandible, pelvis and long bones with a potential for recurrence. We report a case of desmoplastic fibroma of the frontal bone in a young male.
BACKGROUND: Lumbar disc prolapse is a common problem and the current surgical standard for its treatment is a microsurgical discectomy. Microendoscopic discectomy (MED) is a minimally invasive spinal procedure being done successfully for prolapsed intervertebral disc disease. AIMS: We report the technique, outcome and complications seen in 107 cases of prolapsed lumbar intervertebral disc who underwent MED. SETTING AND DESIGN: The study was carried out at the Department of Neurosurgery, at a tertiary hospital in South India and the data was collected prospectively. MATERIALS AND METHODS: 107 patients with prolapsed lumbar intervertebral disc who were seen at our institution between November 2002 and January 2006 were included in the study. Data was collected prospectively. The METRx system (Medtronic Sofamor Danek, Memphis,TN) was used to perform MED. Outcome assessment was done by the modified Macnab criteria. RESULTS: 107 patients (67 males, 40 females) underwent MED for prolapsed lumbar intervertebral disc. Follow up ranged from 2 to 40 months with a mean follow up 12.9 months. Seventy six patients had an excellent outcome, 22 patients had a good outcome, 5 patients had a fair outcome and 3 patients had a poor outcome. One patient with a long dural tear required conversion to a standard microdiscectomy and was excluded from outcome assessment. Complications included dural puncture with K-wire (1), dural tear (2), superficial wound infection (1), discitis (1) and recurrent disc prolapse (2). CONCLUSIONS: Microendoscopic Discectomy (MED) is a safe and effective procedure for the treatment of prolapsed lumbar intervertebral disc.
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A case-control study was conducted to understand the risk factors associated with kala-azar in disease-endemic areas of Bihar, India. A total of 134 kala-azar cases treated at the Rajendra Memorial Research Institute of Medical Sciences in Patna and 406 healthy controls selected randomly from the neighborhoods of cases in their native villages were included in the study. Univariate analysis showed that education, a history of other diseases in the previous year, a history of kala-azar in the family, type of walls in houses, presence of a granary inside houses, presence of vegetation around houses, bamboo trees near houses, and irregular spraying around houses with DDT were risk factors. Multivariate analysis showed that a history of other diseases in the previous year (odds ratio [OR] = 3.6, P = 0.002), a history of kala-azar in the family (OR = 1.8, P = 0.03), mud-plastered walls in houses, (OR = 2.4, P = 0.0001], a granary inside houses (OR = 4.3, P = 0.0001), presence of bamboo trees around houses (OR = 2.3, P = 0.001), and houses not sprayed with DDT in the past six months (OR = 3.4, P = 0.0001) were significant risk factors for kala-azar. These results will be useful in developing kala-azar control programs for identifying intervention strategies such as better housing, regular and proper insecticide spraying, and promoting health awareness to the community residing in disease-endemic areas for reducing transmission and incidence of this disease.
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Superior vena cava (SVC) syndrome often presents with slowly progressive symptoms worsening over weeks or may cause abrupt symptoms and constitute a true medical emergency. Percutaneous intervention is the treatment of choice. We report a case of SVC stenting in a middle-aged woman with SVC obstruction secondary to portacath insertion for chemotherapy.
Coronary dissection is one of the most frequently occurring complications during coronary interventional procedures. However, extensive coronary dissection retrograde to the coronary sinus of Valsalva and to the arch of aorta is very rarely observed. The authors report a case of retrograde coronary dissection extending into the arch of aorta. Management and coronary angiography at 6-month follow-up are discussed.
An anomalous origin of the coronary artery is an infrequent finding on coronary angiogram. Percutaneous coronary intervention may sometimes be difficult in such situations. We report two cases of anomalous coronary arteries in whom direct stenting was done via the radial approach.
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Stent dislodgment during percutaneous coronary intervention is a rare complication. We report a case of successful retrieval of a dislodged stent from the left main coronary artery. It was retrieved via the transradial route using a 6 F coronary guiding catheter supported by an inflated percutaneous transluminal coronary angioplasty balloon distal to the stent.
A tear in the proximal segment of an Inoue balloon was encountered during the dilatation of a calcific mitral stenosis. As a troubleshooting measure, we modified the steps of the standard Inoue technique. The mitral valve was successfully dilated using the same Inoue balloon.
BACKGROUND: Coronary angioplasty and stent implantation is effective as primary intervention in acute myocardial infarction. Because of fewer puncture site complications and improved patient comfort, transradial access has been increasingly used as an alternative to transfemoral access for percutaneous coronary interventions. METHODS AND RESULTS: We studied 103 patients (94 men, 9 women: mean age 52.5 +/- 11.96 years) with a diagnosis of acute myocardial infarction (<12 hours after onset), who underwent primary percutaneous coronary intervention. Transradial access was used in all patients with a normal Allen's test and transfemoral access was used additionally only if intra-aortic balloon counterpulsation was required. Follow-up duration was 6 months. Transradial access was successfully achieved in all patients. Radial artery cannulation took <2 min in more than 85% patients. During percutaneous coronary intervention, cannulation to balloon inflation times and total procedure times were 11.3 +/- 5.2 min and 19.9 +/- 10.8 min, respectively. Stents were implanted in 99 (96.1%) patients andplain balloon angioplastywas performed in 3.9%. The primary success rate was 98.1%, with no major bleeding complications. Total length of hospitalization averaged 2.4 +/- 0.8 days. In-hospital major adverse clinical events rate was 5.9%. Six-month clinical follow-up was achieved for 84 (86.6%) patients. Six (7.1%) patients died during follow-up. Follow-up coronary angiography was performed in 22 (26.2%) patients. After 6 months, 7 patients required revascularizationof the target lesion. The rate of survival without myocardial infarction, bypass surgery or repeat coronary angioplasty was 88.5% at 6 months. CONCLUSIONS: Transradial access may represent a safe and feasible technique for performing primary percutaneous coronary intervention with good acute results and without major bleeding complications.