North Bengal Medical College

About: North Bengal Medical College is a other organization based out in Darjeeling, India. It is known for research contribution in the topics: Population & Cancer. The organization has 624 authors who have published 691 publications receiving 5492 citations.

Endodermal sinus tumor of the vagina in children: a report of two cases.

Abstract: Malignant tumors of the vagina in infants and children are rare, with primary germ cell tumor (endodermal sinus tumor [EST]) being rarer, which carries a dismal prognosis. This tumor is often clinically mistaken as botryoid rhabdomyosarcoma and, on histopathological examination, is often misdiagnosed as clear cell adenocarcinoma. Two cases of EST of the vagina in infants aged 9 and 17 months are reported. Both the patients presented with bleeding per vagina and clinically and by ultrasonography were diagnosed as sarcoma botryoides. Both were diagnosed as primary yolk sac tumors. The serum alfa fetoprotein (AFP) level was 4325 and 9328 ng/ml, respectively. One patient aged 9 months expired 2 months after receiving chemotherapy. The other, aged 17 months, was given chemotherapy followed by surgery with reduction of the AFP levels.

Encephalitis Following Wasp Sting

Abstract: Sir, Hymenoptera stings are encountered worldwide; single sting may result in anaphylaxis. Multiple stings cause shock, renal failure, intravascular hemolysis or rhabdomyolysis. Exceptionally, serum sickness, vasculitis, neuritis, encephalitis are also reported. Neurological complications manifest days to weeks after stings. The authors report a girl who developed allergic encephalitis days after being stung by multiple wasps. A 3-yr-old previously healthy girl presented with head ache, vomiting, seizure and drowsiness. History of multiple wasp stings with local reaction was elicited. She was stable by symptomatic management but started having neurological symptoms on day 4. Examination showed; GCS (9/13), spasticity in four limbs, brisk reflexes and bilateral extensor planter. Meningial signs of cranial nerve palsies were absent. Investigations detected; normal hemoglobin and platelets with marked neutrophilic leukocytosis. CSF analysis showed 10 mononuclear cells, protein was 120 mg/dl; sugar was 50 mg/dl (blood sugar of 94 mg/dl). CSF and serum for Japanese encephalitis virus and dengue antibody were negative. Renal function tests, liver function tests, urinalysis and electrocardiography were normal. Hymenoptera induced delayed allergic encephalitis was diagnosed. Intravenous methylprednisolone was administered (30 mg/kg/day, for 5 days) along with symptomatic management. She regained consciousness but motor impairment persisted. Physiotherapy was initiated in continuation to anticonvulsant medication. Follow up revealed further improvement. Hymenoptera induces, acute IgE mediated type I hypersensitivity. Type III reaction with deposition of immune complexes and activation of complement system occur days to weeks after sting. Neurological involvements are uncommon; onset varies from 30 s to 96 h. Reported complications are peripheral or facial neuropathies, myelitis, encephalitis, encephaloradiculoneuritis, optic neuropathy [1] myasthenia gravis, cerebral infarction, acute inflammatory polyradiculopathy, brachial neuropathy, trigeminal neuritis and generalized polyneuropathy [2]. The cerebral lesions consist of edema, hemorrhage, infarction, necrosis and degeneration. Mechanisms include vasoconstriction, platelet aggregation and retrograde stimulation of superior cervical ganglion causing occlusion of terminal internal carotid artery. Means et al. reported a case of bilateral limbs weakness and numbness; following a yellow jacket sting. Necropsy revealed areas of demyelination throughout central and peripheral nervous system with necrosis and inflammatory infiltration in the brain stem and spinal cord [3]. P Likittanasombut et al. reported severe encephalomyeloradiculoneuritis. [4] Pathogenesis of M. Roy :M. Chatterjee Pediatric Medicine, North Bengal Medical College & Hospital, Darjeeling, West Bengal, India

Nasogastric tube insertion in anaesthetised, intubated adult patients: A comparison between three techniques

Abstract: Background and Aims: The existence of several methods for proper placement of nasogastric tube (NGT) and introduction of various novel methods day-by-day indicates that no method is perfect or universally accepted. However, the quest for the best is still on. Application of cold in various forms to stiffen the NGT has been tested inconsistently over the last three decades. In the recent past, frozen NGT has been compared only with conventional methods. Hence, the present study was designed to evaluate the efficacy of the frozen technique in comparison with conventional and reverse Sellick's manoeuvre. Methods: A total of 195 adult patients undergoing abdominal surgeries in anaesthetised and intubated state requiring NGT insertion were allocated to three groups to have their NGT placement using either the conventional method (Group A) or using frozen NGT (Group B) or applying reverse Sellick's manoeuvre (Group C). The number of successful placements of NGT within two attempts, procedure time, and incidences of adverse events were noted. Results: The highest success rate regarding the successful placement of NGT was observed using reverse Sellick's manoeuvre (95.2%), closely followed by the frozen NGT technique (84.6%) in comparison with conventional method (69.2%). The procedure time was the least with reverse Sellick's manoeuvre (31.5 ± 9.5 s) compared with conventional (42.2 ± 21.4 s) and frozen technique (42.1 ± 13.2 s). Conclusion: Nasogastric tube insertion using reverse Sellick's manoeuvre shows the highest success rate and having the least adverse events among the compared three methods in anaesthetised, intubated adult patients.