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An Unwonted, Pedagogic Case Report on Effort Thrombosis of Right Brachial Vein

Open Journal of Emergency Medicine 2022年第1期10卷 8-18页

作者： sayani banerjee Department of Emergency Medicine Calcutta Medical Research Institute Kolkata India

Deep vein thrombosis (DVT) is one or more blood clots formed inside the deep vein in the body resulting in complete or partial blockage of blood flow through the affected vein. Upper Extremity DVT (UEDVT) accounts for 5% - 10% of all cases of DVTs. Previously it was thought to be a rare disorder. However in recent years with the advent of various indwelling intravenous devices, hypercoagulable state like COVID-19, secondary UEDVT did not remain infrequent presentation anymore. Though primary UEDVT, also known as Effort Thrombosis, that takes place without any underlying obvious pathology is a rare form till now. We presented a case of 46 years female who presented to the emergency with complaints of progressively increasing pain (7 days) and swelling (3 days) of her right forearm since last 7 days following strenuous and heavy work by her dominant/ right hand during the period of festival. She initially ignored her condition because of the Durga Puja festival. As her symptoms deteriorated she eventually had to attend the emergency department. Eventually an urgent ultrasonography color Doppler was done on emergency basis which diagnosed underlying DVT of her right brachial vein. She was managed with low molecular weight heparin, urgent fasciotomy owning to her impending compartment syndrome. Other tests ruled out any secondary underlying pathology. She improved and discharged without any complications on oral anticoagulant. Exigent events in her history were trauma followed by fall on her right elbow 2 months back and then presenting signs & symptoms commencing at the same region following strenuous, tedious activities over 7 days and consequential effort thrombosis of her right brachial vein. All of that compelled us to ruminate on rare differentials of her presentation and eventually come to this rare diagnosis. The author hence brought this pedagogic case to the readers, especially emergency & primary care physicians and emphasised the importance of being intuitiv

关键词： Deep vein thrombosis Upper limb DVT Effort thrombosis

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Losartan Induced Angioedema, a Rare Case Report and the Dilemma of Using Angiotensin II Receptor Blockers in Patients with Previous Angioedema with Angiotensin Converting Enzyme Inhibitors

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Open Journal of Emergency Medicine 2024年第3期12卷 69-76页

作者： sayani banerjee Abdul Sajjad Pathan Department of Emergency Medicine Weston General Hospital University of Bristol & Weston NHS Foundation Trust Weston Super Mare UK Department of Emergency Medicine Royal Surrey NHS Foundation Trust Guilford UK

Angiotensin Receptor Blockers (ARB) are used as an alternative of Angiotensin Converting Enzyme Inhibitors (ACEI) in patients where ACEIs cannot be used because of their known adverse effects, cough and angioedema. Thus ARB induced angioedema is considered to be a rare phenomenon and it is continued to be used as an alternatives of ACEIs. In this case report, we reported a case of 78-year-old gentleman who presented to emergency department with losartan, an ARB induced angioedema, who did not have history of any previous use of ACEIs. He was given steroids and antihistamine as a treatment. His angioedema resolved rapidly and he was discharged after six hours of emergency department (ED) observation with stable hemodynamically. We, the authors by reporting this case, wants to make clinicians aware ARB, however rarely, can cause angioedema, which can be life threatening if clinicians are not aware of it and diagnose and stop the offending drug promptly and treat it early.

关键词： Angioedema Airway Emergency Acute Presentation

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A Case Report on Atypical Presentation of Cerebral Venous Sinus Thrombosis, a Young Adult with Recurrent Fall: A Clinical Quandary

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Open Journal of Emergency Medicine 2021年第4期9卷 171-178页

作者： Aishwarya Nandy sayani banerjee Rajesh Gupta Department of Emergency Medicine Ramkrishna Care Hospital Raipur India Department of Emergency Medicine Calcutta Medical Research Institute Kolkata India Department of General Medicine Ramkrishna Care Hospital Raipur India

Cerebral Venous Sinus Thrombosis (CVST) is blood clot in draining veins and venous sinuses of brain, causing hindrance in the blood drainage system in brain, disturbing the internal homeostasis of brain, resulting in local oedema, ischemia, venous haemorrhage, damage to brain parenchyma and blood brain barrier. In our case report, we discussed a rare presentation of CVST, a 16-year-old young boy who presented in emergency with history recurrent fall, weakness, tingling numbness. What makes it challenging to diagnose in his unusual presentation without common symptoms and on examination no positive neurological finding. This case brings focus on the importance of knowledge about CVST among emergency physicians. CSVT is considered more commonly as a differential diagnosis of stroke in young age group owning to genetic predisposition, hot humid climate of the state leading to severe dehydration, dietary factors leading to vitamin B12 deficiency & hyper-homocysteinemia etc. Moreover, present COVID-19, inducing a hypercoagulable state among affected individuals gave CVST a new momentous among emergency physicians. An early diagnosis can be very fruitful as it might prevent long term disability and reduce mortality significantly.

关键词： Cerebral Venous Sinus Thrombosis Acute Neurological Emergency Atypical Presentation

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A Case Report of Pediatric Cerebral Venous Thrombosis with Undiagnosed Complex Congenital Heart Disease: Tetralogy of Fallot with OS ASD: A Cataclysmic Ending

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Open Journal of Emergency Medicine 2022年第2期10卷 111-123页

作者： sayani banerjee Aishwarya Nandy Santosh Kumar Singh Department of Emergency Medicine Weston General Hospital University Hospital Bristol & Weston Weston Super Mare UK Department of Emergency Medicine Ramkrishna Care Hospital Raipur India

Cerebral Venous Sinus Thrombosis (CVST/CSVT) is occlusion of cerebral veins and venous sinuses of brain secondary to blood clot formation resulting in hindrance in the blood drainage system in brain, leading to disturbances the internal homeostasis of brain, raised intracranial pressure, cerebral edema, and 50% of cases will have venous infarction or venous hemorrhage (stroke). CVST although being a Rare disorder but may be more common in children than adults with greater risk in neonatal period i.e. first 28 days of life. Here we are discussing a case of Pediatric CVST in a 7-month-old baby boy who presented to Emergency Room (ER) with recurrent discrete episodes of vomiting, fever, seizures, drowsiness and respiratory distress. The fatal outcome in our child was attributed to delayed presentation in a tertiary care center, hence missed early diagnosis and treatment. In this child the CVST could be result of amalgamation of complex underlying ongoing multiple pathological processes: an acute systemic illness like sepsis, severe dehydration, undiagnosed and untreated complex congenital heart disease, tetralogy of fallot with osteum secondum atrial septal defect, worsening the coagulopathy. It takes this case even more unique. This discussion is to bring focus on the importance of knowledge about CVST amongst emergency physicians and primary care physicians, specially managing this rare disorder with flummox presentation mimicking other more common disorders, especially in pediatric and neonatal population where definitive history and chief complaints are often vague and difficult to obtain, making it more difficult to diagnose. We the authors hence reporting this case with intent to spread awareness of CVST, how to doubt it, detect it and then manage it, especially in places like Chhattisgarh, India, where CVST is not so uncommon. We believe early diagnosis, early presentation to tertiary care center with aggressive early treatment can significantly reduce the morta

关键词： Cerebral Venous Sinus Thrombosis (CVST) Pediatric CVST Tetralogy of Fallot (TOF) Osteum Secondum Atrial Septal Defect (OS ASD)

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A novel method for predicting bradycardia and atrial fibrillation using fuzzy logic and arduino supported IoT sensors

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Medicine in Novel Technology and Devices 2021年第2期10卷 41-51页

作者： Partha Sarathi banerjee Amiya Karmakar Mainak Dhara Kaustabh Ganguly sayani Sarkar Kalyani Government Engineering College KalyaniWest BengalIndia

Dormant Cardiovascular diseases(CVDs)are found to take a death toll of 17.9 million every year *** propose an application that reads the heart beat using pulse *** system accumulates and analyzes data using Arduino based *** analyzer reads the pattern of heart-beat using fuzzy-normal distribution to find out whether the data belong to a normal heart or a damaged *** analyzer can efficiently indicate the occurrence of Bradicardia or atrial fibrillation or no *** have proposed an app‘StepSuggest’that can suggest the user about the number of steps he/she should walk during workout.

关键词： Internet of things Cardiovascular disease Arduino

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