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( Manoj Behera ),( Pk Julka ),( Gk Rath ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: The standard adjuvant therapy for transmural and/or node +ve rectal cancer is the combination of pelvic radiation with 5FU based chemotherapy, which significantly improves both local control and overall survival. The addition of concurrent chemotherapy to neoadjuvant radiotherapy increases pathological complete response and down staging occurs in about 60% and which may facilitate sphincter preserving surgery in distally located tumors Methods: A total of 50 patients of locally advanced carcinoma rectum were studied from July 2010 to December 2011. Patients with clinical T3 / T4 and N1/N2 cancer of distal rectum were subjected to receive concurrent chemoradiation followed by surgical resection. All the patients were given Tab. Capecitabine@825 mg/m2 twice concurrently with radiation of 45 Gy/25# @ 1.8 Gy for 5 weeks. Surgery was performed 4-6 weeks after completion of chemoradiation. Tumor downstaging and sphincter preservation were the primary endpoints. Acute normal tissue toxicities were taken into account as secondary point. Postoperatively patients with high risk pathological features were treated with adjuvant chemotherapy with FOLFOX regimen. Results: This regimen resulted in overall resectability rate of 75% and a sphincter preservation rate of 40%. The complete pathological response rate was 40%. Diversion colostomy was done in 25% patients who were declared inoperable. Non hematological toxicities viz: diarrhea grade III = 21% and skin reaction grade II =16%; grade III= 5%). Grade II neutropenia (5%) and grade I thrombocytopenia (2%) were the hematological toxicity observed. With a median follow up period of 9 months no loco-regional failure has been seen. Conclusions: Concurrent preoperative chemoradiation for locally advanced carcinoma rectum is associated with improved tumor resectability which results in improved sphincter preservation, local control and is relatively safe, effective and well tolerated.
Pulmonary Strongyloidiasis Masquerading as Exacerbation of Chronic Obstructive Pulmonary Disease
Pradhan, Gourahari,Behera, Priyadarshini,Panigrahi, Manoj Kumar,Bhuniya, Sourin,Mohapatra, Prasanta Raghab,Turuk, Jyotirmayee,Mohanty, Srujana The Korean Academy of Tuberculosis and Respiratory 2016 Tuberculosis and Respiratory Diseases Vol.79 No.4
Pulmonary strongyloidiasis is an uncommon presentation of Strongyloides infection, usually seen in immunocompromised hosts. The manifestations are similar to that of acute exacerbation of chronic obstructive pulmonary disease (COPD). Therefore, the diagnosis of pulmonary strongyloidiasis could be challenging in a COPD patient, unless a high index of suspicion is maintained. Here, we present a case of Strongyloides hyperinfection in a COPD patient mimicking acute exacerbation, who was on chronic steroid therapy.
Pulmonary Strongyloidiasis Masquerading as Exacerbation of Chronic Obstructive Pulmonary Disease
( Gourahari Pradhan ),( Priyadarshini Behera ),( Manoj Kumar Panigrahi ),( Sourin Bhuniya ),( Prasanta Raghab Mohapatra ),( Jyotirmayee Turuk ),( Srujana Mohanty ) 대한결핵 및 호흡기학회 2016 Tuberculosis and Respiratory Diseases Vol.79 No.4
Pulmonary strongyloidiasis is an uncommon presentation of Strongyloides infection, usually seen in immunocompromised hosts. The manifestations are similar to that of acute exacerbation of chronic obstructive pulmonary disease (COPD). Therefore, the diagnosis of pulmonary strongyloidiasis could be challenging in a COPD patient, unless a high index of suspicion is maintained. Here, we present a case of Strongyloides hyperinfection in a COPD patient mimicking acute exacerbation, who was on chronic steroid therapy.
Sahoo Alok Kumar,Misra Satyajeet,Behera Bikram Kishore,Srinivasan Anand,Jena Sritam Swarup,Mohanty Manoj Kumar 대한마취통증의학회 2022 Korean Journal of Anesthesiology Vol.75 No.2
Background: Subanesthetic intravenous (IV) ketamine acts as an analgesic and has opioid-sparing effects, particularly for acute postoperative pain; however, its effectiveness in children is understudied. The primary aim of this study was to evaluate the non-inferiority of subanesthetic IV ketamine vs. caudal bupivacaine for postoperative analgesia in children undergoing infraumbilical surgery.Methods: Children aged < 6 years were enrolled in this single-blind study and randomized to receive either subanesthetic IV ketamine (0.3 mg/kg) or caudal 0.125% bupivacaine (1 ml/kg) along with general anesthesia. Postoperative pain was assessed using the FLACC scale at 30 minutes and 1, 2, 3, and 6 h post-operation. Intra- and postoperative opioid consumption, time to extubation, postoperative vomiting, agitation, sedation, and inflammatory markers were also assessed.Results: Altogether, 141 children completed the study (ketamine group: n = 71, caudal group: n = 70) The cumulative proportion of children without significant postoperative pain (FLACC score < 4) in the first 6 h post-surgery was 45.1% in the ketamine group vs. 72.9% in the caudal group (P < 0.001). More children in the ketamine group required an additional dose of intraoperative fentanyl (33.8% vs. 5.7%, P < 0.001) and postoperative tramadol (54.9% vs. 27.1%, P < 0.001). However, postoperative agitation, sedation, and other secondary outcomes were similar between the groups.Conclusions: Subanesthetic ketamine is inferior to caudal bupivacaine for postoperative analgesia in children aged < 6 years undergoing infra-umbilical surgeries; however, other postoperative outcomes are similar.