Sunday, January 09, 2011

Dr. LN Tripathy


Dr. LN Tripathy, originally uploaded by sswain_1999.

52nd Annual Conference of IMA, Rourkela Branch

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1 comment:

  1. DR.SUKANTA DAS12:37 PM

    case history : MR. DILIP KUMAR DAS ( 63 YR/H/M)

    my dad had an GTCS on 1'st week of may & minor injury over face..he was unconscious for < 5 mints.Urgently CT SCAN BRAIN (plain ) done.He was prescribed Tab. Gardenal ( 60 mg ) 1 Tab ODHS..after 2 weeks he felt Lt. sided Upper extremity weakness mainly Hand & gradually forearm.On 11th he felt on sitting posture but no convulsions,no involuntary bladder/bowel,no other thing..but recieved a sharp injury over Occipital region..3 stiches given...a repeat CT SCAN BRAIN done..but now he feels Lt. sided paresis which is progressing rapidly..
    He is known Diabetic on Glimiperide(1mg) OD morning BBF + metformin ( 500 mg ) 1 tab OD before Dinner.
    also known HTN on Tab Stamlo ( 2.5 mg) OD..
    Both are under controll....
    Past H/O TB 20Yrs back..treated.
    KNOWN SMOKER 40 PACK YEAR BUT NON-ALCOHALIC

    following INVESTIGATIONS done................................
    -----------------------------------
    plasma Glucose (F)-99 mg/dl.Urea-34mg/dl.Creatinine-1.14mg/dl.Na-137mEq/L.K-3.9mEq/L.

    LFT-normal.
    USG Whole Abdomen--
    1.B/L simple renal cysts.-? B/L Chronic Renal parenchymal disease.
    2.other within normal limit.

    CT SCAN OF BRAIN (06/05/12):
    ?Acute infarct at Rt. MCA territory.

    repeat CT BRAIN ( 11/06/12):
    RING lesion at Rt. Parietal lobe with gross white matter Oedema -as compared to prev. CT.

    MRI BRAIN with contrast (22/05/12):
    Rim enhancing small cystic lesion in Rt. Parietal Lobe with perilesional edema but no remarkable mass effect consistent with Granuloma likely NEUROCYSTICERCOSIS. SIZE:0.8 cm * 0.8cm.

    CHEST X-RAY (PA)Digital : NAD.

    Digital X-RAY Of both Thigh (AP & Lat.):
    Osteophytes seen at articular margin of both acetabuum.-? OsteoArthrosis of both hip joint.

    ECG :RBBB with LAHB -Bifascicular heart block.

    Sputum for AFB (3 days)- negetive.
    NEXT, I TOOK HIM TO SRI NARAYANI HOSPITAL,THIRUMALAIKODI,VELLORE.
    AFTER CONSULTING WITH DR.HRISHIKESH SARKAR ( NEUROSURGEON)

    REPEAT MRI DONE (26/06/12)
    WHICH SHOWING RIM ENHANCING MASS LESSION WITH HUGE OEDEMA .SIZE: 2.1 cm*2 cm.
    he suggest for PETCT done on 11/07/12..
    REPORT PENDING......

    NO FURTHER DETERIORATION OBSERVED...BUT PSHYCHOLOGICALLY VERY DEPRESSED...
    HE STARTED WITH TAB.DEXAMETHASON (4 mg) BD...NO RAPID IMPROVEMENT NOTED AS FAR.

    PET CT WITH FDG DYE DONE FROM TATA MEMORIAL HOSPITAL,KOLKATA DONE ON JULY'12 SHOWING A SMALL RADIO-ACTIVE NODULE ON POST. ASPECT OF Rt. UPPER LOBE..
    NEXT,CECT THORAX DONE & CT GUIDED FNAC DONE BY Dr.Usha Goanka IN APOLLO HOSP.,KOLKATA....HistoPathology done by DR.ENAM, MURSHED KHAN AS...
    SMEARS ARE OF SCANTY CELLULARITY SHOWING RBCs,WBCs,ALVEOLAR MACROPHAGES & A FEW BENIGN EPITHELLIAL CELLs.NO MALINGNANT OR GRANULOMA CELLS.CELL BLOCK IS NON CONTRIBUTARY... ORGANIZING INFLAMMATION...

    SO PROBABLY PRIMARY BRAIN TUMOR...

    NOW I WOULD LIKE TO MEET WITH YOU...FOR MAKING DECISION ABOUT SURGERY...
    --
    wan 2 know the cost of Surgery+Post Operative ...
    thank you so much...need ur blessings...

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