BIANNUAL OFFICIAL NEWSLETTER

Smt. B. K. Shah

Medical

Institute &

Research

Centre

MEDICAL APOGEE VOLUME-2

HON’BLE PRESIDENT DR.DIXIT SHAH

HON’BLE CHANCELLOR DR. HARSHAD SHAH

HON’BLE VICE CHACELLOR DR. R. P.BHARANEY

2020

Biannual Official Newsletter Smt. B. K. Shah Medical Institute

& Research Centre

Dean : Dr.PareshGolwala.

Chief Editor: Dr. Punit Singh

Associate Professor, Department of Ophthalmology

Co-Editors: Dr. Aditya Agrawal

Associate Professor, Department of Orthopaedics

Dr.Honeypal Singh Maharaul

Associate Professor, Department of General Surgery

SBKS MI&RC, PIPARIA , WAGHODIA, VADOADRA

MESSAGE FROM CHIEFEDITOR

“While writing is like a joyful release, editing is a

prison where the bars are my former intentions and

the abusive warden my own neuroticism.”― Tiffany

Madison

It gives me immense pleasure to write editorial for this

newsletter. SBKS MI&RC journal with a vision to promote

best medical teaching and care of patient , hope that this

newsletter fulfill the purpose to inform ,engage and

inspire the diverse readership and help in expanding the

horizon of knowledge.

Dr Punit Singh

Chief Editor

MESSAGE FROM DEAN’S DESK

Medical Education Challenges the best and the brightest minds to learn the science of medicine and public health; and the art of compassionate care. As one of the nation’s premier medical institution; Smt.B.K.Shah Medical College

And Research Center (SBKS MI&RC) is dedicated to advancing biomedical knowledge and humane healing

through innovative educational methods. In recent years; our SBKS MI&RC has become best place to pursue an

education with totally modernized facilities; a redesigned curriculum that introduces early clinical experiences; and new academic partnerships and global initiatives; we are pointed aggressively to the future. We select each new

entering class with the intent of ensuring that we will train tomorrow’s medical leader ; secure in the knowledge that

they will be well prepared to practice their chosen specialties and to meet the needs of the public. I look

forward to providing highlights of their contributions in the upcoming months.

Dr. Paresh P. Golwala

Dean

Medical Education Unit

Online session on “Use of technology in online student assessment” held on 26-05-20

ONLINE SESSION ON “USE OF TECHNOLOGY IN ONLINE STUDENT ASSESSMENT” HELD ON 26-05-20 BY

MEDICAL EDUCATION UNIT

Objectives: To make the faculties oriented about the various platforms for online assessment. Brief Information on Proceeding: The Program was started at 3.00 pm with total no. of 378 Participants attending. The link was sent to all heads of institution. Following that faculty from various institutions attended this in their institutional seminar rooms through online platform with social distance maintenance. The Resource Person, Dr Chinmay Shah (Associate Professor & Head, Dept. of Physiology, GMC, and Bhavnagar) explained in details about the various platforms used for online Assessment with demonstration. He additionally gave more insight into Google classroom, Google form, online OSPE & Viva. Conclusion: All the participants found this event very useful during this where online teaching learning & assessment is the only option to continue academic commitments.

DEPARTMENT OF MEDICINE

Conference on “Critical Care In Tropical Infections”

held on 07-02-20

CONFERENCE ON “CRITICAL CARE IN TROPICAL INFECTIONS”

HELD 07-02-20 BY DEPARTMENT OF MEDICINE

Objectives: To represent the challenges occuiringin critical care in tropical infections. Name of Organizing Chairperson was Dr. Hetal Pandya & Name of Organizing Secretary was Dr. Drishti Khatri Brief Information on Proceeding : Session was started with acute complications of malaria vaccine preventable disease in adults , rational use of antibiotics, emergencies in leptospirosis , various aspects of urosepsis, critical care complications in dengue fever. Conclusion: There were 301 participants who attended the event and it was concluded with the importance of critical care management in tropical infections.

DEPARTMENT OF MEDICINE

CME on“2019 Novel Corona Virus” held on 13-02-20

CME ON“2019 NOVEL CORONA VIRUS” HELD ON 13-02-20 BY

DEPARTMENT OF MEDICINE

Objectives : To introduce the novel corona virus and its epidemics. Name of Organizing Chairperson was Dr. G. V Shah & Name of Organizing Secretary was Dr. Hetal Pandya Introduction of the Event / Activity : Seminar on “2019 Novel Corona Virus” was conducted by Department of Medicine. Conclusion : There were total 263 participants who all attended this event and it was concluded with a good discussion.

DEPARTMENT OF MICROBIOLOGY

Training program on “Best practices in Infection control” held

on 05-02-20

TRAINING PROGRAM ON “BEST PRACTICES IN INFECTION

CONTROL” HELD ON 05-02-20 BY DEPARTMENT OF

MICROBIOLOGY

Objectives: To introduce best practices of infection control to nursing students Name of Organizing Chairperson was Dr V S Date Name of Organizing Secretary was Dr Sucheta Lakhani Brief information on proceeding: This event was conducted by Department of Microbiology for the Nursing students. Conclusion: 150 Students attended the event and learnt various methods of infection control and were satisfied.

DEPARTMENT OF OPHTHALMOLOGY

GLAUCOMA SYMPOSIUM ORGANIZED

BY GLAUCOMA SOCIETY OF INDIA-02-02-2020

Dr Punit Singh, AssociateProfessor Ophthalmology department

was invited as guest speaker at Baroda ophthalmic society as

Glaucoma Specialist.

DEPARTMENT OF PHARMACOLOGY

CME on“Current Trends in Management of Neurological Disorders” held on 27-02-20

CME ON“CURRENT TRENDS IN MANAGEMENT OF NEUROLOGICAL DISORDERS” HELD ON 27-02-20 BY

DEPARTMENT OF PHARMACOLOGY

Objectives: Updating the new approaches available for management of neurological disorders. Name of Organizing Chairperson and Secretary was Dr. Maulin Mehta Brief Information on Proceeding : Opening remarks were given by respected Dean, Dr. G.V. Shah. All three sessions were started in time and ended in time with sufficient time for discussion. The sessions were interactive and interesting. Conclusion: All three speakers were rated between excellent to very good. All the participants found it to be very helpful and informative. They are interested to have more of such CME programs. Overall the event was rated as Good.

CASE REPORT

1.DEPARTMENT OF ANAESTHESIA

ANESTHETIC MANAGEMENT OF A PATIENT FOR AWAKE CRANIOTOMY WITH “ASLEEP AWAKE ASLEEP” TECHNIQUE.

Authors:

Tejash Sharma, Dr Jatin Patel, Akhilesh Chhaya

Associate Professor, Department of Anaesthesiology, Smt. B. K. Shah

Medical Institute & Research Centre, Sumandeep Vidyapeeth an

Institution Deemed to be University, Piparia-391760, Waghodia,

Vadodara, Gujarat, India.

Professor, Department of Anaesthesiology, Gujarat Adani Institute of

Medical Sciences, Bhuj, Gujarat, India.

Corresponding author: Dr Tejash Sharma, E-mail id:

drtejash@gmail.com Mb. No. 9427332100

ABSTRACT

A neurosurgery like awake craniotomy allows surgeon to resect a tumour from safe margins and provides better post-operative neurological deficit. But at the same time it surfaces greater challenges to the anaesthesiologists. A 40 year male with low-grade glioma tumour in left fronto-parietal lobe presented for craniotomy under American society of anesthesiologist (ASA) class II. For allowing resection of maximum tumour and avoidance of

neurologic morbidity an awake craniotomy was planned. After the premedication the patient was induced with inj. Propofol , inj. fentanyl andinj. bupivacaine with adrenaline was infiltrated for placement of scalp fixator (Mayfield fixator) and skin incision. Airway was maintained with nasopharyngeal airway on spontaneous respiration, propofol infusion was discontinued to make patient conscious, hence cooperative for neurological testing during the procedure. Speech and motor testing were carried out. The propofol infusion was resumed as soon the cranium was closed and fixator was removed. Speech and motor function were intact except for mild weakness in the right forearm. This type of procedure needs proper patient selection, experienced surgeon and a well planned anesthesia. This case report describes anaesthesia management for awake craniotomy.

2.DEPARTMENT OF PEDIATRICS

Year – 2019 – 2020

Dr. Putun Patel, Assistant professor, dept of Paediatrics

Dr. Manish Rasania, Professor, dept of Paediatrics

Niyati Parikh, Resident doctor, dept of Paediatrics

CASTLEMANS DISEASE- A CASE REPORT.

INTRODUCTION

Castleman disease (CD) is an unusual lymphoproliferative disorder

of unknown cause. Reactive lymphoproliferative process in

response to an unknown stimulus and defective immune regulation

may be involved in its pathogenesis.

CASE REPORT

A 14-year old male patient presented to us with complaints of right

inguinal swelling of 2 * 2 cm for last 3 to 4 months. Swelling was

firm, mobile, gradually increasing in size. Also associated with

weight loss and decreased appetite. On histopathology (HP) of

inguinal lymph node showed few follicles within lymphoid tissue. A

few vessels are seen with thick and hyalinized wall and the

interfollicularstroma shows numerous sheets of plasma cells.

Immunohistochemistry (IHC) had CD3 and CD 20 highlights reactive

T and B cells, CD138 highlights the plasma cells, Kappa and Lambda

stain confirms the polyclonal nature, CD23 highlights the follicular

dendritic meshwork, CD10 highlights the germinal center. HP and

IHC findings were suggestive of CD plasma cell type. In past, in 2010

child developed cervical lymphadenopathy and in 2017 developed

axillary lymphadenopathy for which biopsy was done and some

treatment was given but no documents were available. At present

patient is given supportive management and kept in close follow up

and has not developed any new swelling.

CONCLUSION

In 1956 Benjamin Castleman and his associates described this

disease. It is also recognized as angiofollicular lymphoid

hyperplasia, giant lymphnode hyperplasia, lymphoid hyperplasia,

benign lymphoma, and follicular lympho-reticuloma. In India 76

cases of CD are reported in pediatric age group and plasma cell type

occurred in 24% of the patients. Prevalence is estimated to be less

than 1 / 100,000. It can present as a localized mass or as a

multicentric disorder. Its presentation as primary cervical

lymphadenopathy accounts for only 6% of cases. Histologically,

three variants are recognized, viz., hyaline vascular, plasma cell

type, and intermediate type. An abnormal production of a B cell

growth factor, such as IL-6, causes lympho-proliferation and plasma

cell differentiation is the key factor in pathogenesis of CD. Localized

disease usually has a benign course and its treatment of choice is

complete excision of the lymph node involved. Multicentric disease

is usually a systemic illness involving retroperitoneum, neck,

parotids and muscles or it can present as a disseminated

lymphadenopathy. It is aggressive and usually the fatal course is

associated with infectious complications and risk for malignant

tumors such as lymphoma or Kaposi sarcoma. For idiopathic

multicentric disease drugs such as Siltuximab,

Tocilizimab, Rituximab and chemotherapy in severe cases can be

offered. In our case patient was a multicentric disease, at present

patient is given supportive treatment and kept under close follow-

up, as patient was reportedly treated outside but no documents are

available. We plan to start chemotherapy if any recurrence found.