Query: Debmalya Saha

title: Implication of preoperative glycosylated hemoglobin level on short term outcomes in diabetic patients undergoing coronary artery bypass grafting
abstract: The post operative morbidity and mortality are increased by five to ten folds in diabetics. The glycosylation of the red blood cells is regulated by blood glucose level; considering the life span of RBC (90 120 days) the circulating blood glucose level and continuous cell turnover lead to formation of HbA1c. Thus, the HbA1c level indicates about the glycemic status of the patient over a period of previous three to four months. In fact, HbA1c gives more information than a blood sugar reading taken at a single time that may change depending on the metabolic demand and short term dietary changes. Currently, HbA1c is considered gold standard to monitor the glycemic control in diabetics.

title: A Case of Giant Mediastinal Liposarcoma of Thymic Origin: A Rare Clinical Entity
abstract: Thymoliposarcoma is an exceedingly rare tumor of thymus with a very few cases reported till date. This case study presents a 45 year male with rare type of thymoma. On the contrast enhanced CT images, there was a large mass lesion of predominantly fat attenuation in the pre vascular compartment of the mediastinum insinuating on both sides of the visceral compartment of the mediastinum, and extending upto the bilateral cardio phrenic and anterior costophrenic angles, anterior to the right ventricle with loss of fat plane with the pericardium, with few sub centimetric lymph nodes in the right paratracheal and AP window and a calcified right hilar lymph node, suggestive of well differentiated liposarcoma/thymoliposarcoma. Initial CT guided tru cut tissue biopsy was inconclusive, and the repeat biopsy revealed as fibro collagenous tissue with area of necrosis, focal myxoid changes in the background with presence of cells which are spindle to oval in shape with mild nuclear pleomorphism and negative for S100, Cytokeratin, CD34, desmin. The entire tumor was resected en masse after meticulous dissection without the support of cardiopulmonary bypass (CPB) with an intact pericardium. Final histopathology report of the surgical biopsy specimens is consistent with dedifferentiated thymoliposarcoma with focal ganglionic cell differentiation. Postoperative follow up CECT of thorax revealed no evidence of residual mass in the pre vascular compartment. The patient is disease free and asymptomatic after 6 month and he is under routine follow up under Radiotherapy department since he received 30 Gy of postoperative radiotherapy (PORT)

title: Konno Procedure for Managing Small Aortic Root during Aortic Valve Replacement Surgery: An Experience of 12 Cases
abstract: Small aortic annulus during aortic valve replacement can lead to implanting a smaller sized valve compared to the body surface area thereby causing patient prosthesis mismatch. Various aortic root enlargement techniques have been described depending on anterior or posterior approach. Konno procedure uses anterior approach for aortic root enlargement. In this study, we reviewed results of Konno procedure done from 2011 to 2019 by a single surgeon.  12 adult patients who underwent aortic valve replacement along with Konno procedure for small aortic root by a single surgeon at a single center between 2011 and 2019 were reviewed. Echocardiographic and demographic data and post operative data were obtained from medical records. Symptomatic profile was assessed as per New York Heart Association Classification. Intraoperative findings and post operative period findings were noted. Follow up symptom profile was assessed for these patients.  12 patients underwent Konno procedure between 2011 and 2019 for small aortic root along with valve replacement. The main indication for surgery was aortic stenosis with small aortic annulus, with or without involvement of the mitral valve. Preoperatively, 3 patients had NYHA class II and 9 patients had NYHA class III symptoms. Mean age at operation was 26.42 years, minimum age 10 years, and maximum age 39 years. 3 were females and 9 were males. Mean bypass time was 106.4 minutes and aortic cross clamp time was 80.67 minutes. Mechanical aortic valves were implanted in all patients. Mean post operative blood loss was 134.2 ml and duration of ventilation before extubation was 14.5 hours. Mean duration of intensive care unit (ICU) stay was 2.83 days and hospital stay was 9.1 days. Mean gradient in the post operative period was 10.75 mm Hg. There was no mortality in these 12 patients and no reoperation was needed in the follow up period. Follow up in the outpatient department suggested all patients had NYHA class I symptoms and anticoagulation with warfarin adjusted to prothrombin time International normalised ratio.  Konno procedure is effective for managing small aortic root as bigger outflow orifice area through the larger valve prosthesis improves ventricular outflow and hence, improves the outcomes.

title: Pictorial Consent in Cardiac Surgery: A far better option rather than Standard Informed Written Consent
abstract: Because of the complexity of the procedures, high level of clarification for the patients as well as their attendants while taking consent is a must as cardiac surgery is associated with significant morbidity and mortality. Pictorial consent with preoperative education is a far better option in this regard. We randomly took a total of 150 patients within the age group of 18 to 70 years, and they were explained with standard consent followed by pictorial consent and vice versa by the same informant. And they were given a preset questionnaire format after both consents. Later, based on their answers, comparison in relation to the level of clarity was done. Questionnaire was formatted after rigorous modification from the reviews of literature.

title: Spatial Position Regulates Power of Tryptophan: Discovery of a Major Groove Specific Nuclear Localizing, Cell Penetrating Tetrapeptide.
abstract: Identification of key amino acids is required for development of efficient cell penetrating peptides (CPPs) and has tremendous implications in medicine. Extensive research work has enlightened us about the importance of two amino acids, arginine and tryptophan, in cell penetration. Here, we present a top down approach to show how spatial positions of two tryptophans regulate the cellular entry and nuclear localization. This enables us to develop short, non toxic tetrapeptides with excellent potential for cell penetration and nuclear localization. Among them, Glu Thr Trp Trp (ETWW) emerges as the most promising. Results suggest that it enters into cancer cells following an endocytic pathway and binds at the major groove of nuclear DNA, where successive tryptophan plays major role. We subsequently show that it is not a P glycoprotein substrate and is non toxic to PC12 derived neurons, suggesting its excellent potential as a CPP. Furthermore, its potential as a CPP is validated in multi cellular 3D cell culture (spheroid) and in in vivo mice model. This study provides major fundamental insights about the positional importance of tryptophan and opens new avenues toward the development of next generation CPPs and major groove specific anticancer drugs.

title: Health monitoring using Internet of Things (IoT)
abstract: Health is the level of useful and metabolic potency of a living organism. In humans, it is the power of people or communities to adapt and self manage once facing physical, mental, psychological and social changes. Keeping track of the health standing of the patient reception may be a troublesome task. Specially maturity patients ought to be sporadically monitored and their adored ones got to learn concerning their health standing from time to time whereas at work. During this paper, our objective is to trace patient's health with the assistance of sensors and internet. Internet is employed to tell their beloved if there is a drag. The health observation system can keep track of patient's pulse rate, eco rate of heart, pressure level rate, temperature etc. If system detects any abrupt changes in patient heartbeat or temperature, the system mechanically alerts the user concerning the patients standing over IOT and additionally shows details of heartbeat and temperature of patient live over the internet.

title: Pollution control using Internet of Things (IoT)
abstract: The change of ecosystem and the surrounding atmosphere by different forms of pollutants (Chemicals and energies) are called environmental pollution. Pollution affects the climate most. The issue of environmental pollution and climate change has become an international concern due to their affects to the physical and biological entities of the environment. In this paper, the main objective is to find the pollutants in nature with the help of the Internet of Things (IoT) The UVI 01 sensor is an ultraviolet light sensor. The UV Sensor outputs an analog signal of the amount of UV light it detects. The 2 in one Temperature and PH sensor is used to monitor the Quality of water, interns of monitoring the level of water, the temperature of the water and its surrounding, the turbidity of the water (how clean the water is) as well as the PH levels of the Water. Therefore, this system monitors all of these result and finally when all data are collected, it sends the information or data to the cloud.

title: Waste management using Internet of Things (IoT)
abstract: Waste management is that the tactic of treating solid wastes and offers reasonably solutions for usage things that don't belong to trash. It's regarding but trash bin be used as a valuable resource. Waste management disposes of the merchandise and substances that we simply have use throughout a secure and economical manner. Researchers are finding out waste management for over a century, and for over forty years waste utilization analysis. There are eight major ways of waste management strategies, every of them divided into various classes. Those are reduction and employ, animal feeding, recycling, composting, fermentation, landfills, burning and land application. We will begin exploitation several techniques right reception, like reduction and employ, that works to cut back the number of disposable material used. Fortunately, IoT has the answer to assist the utilization method at each stage of the waste management.

title: Disaster management using Internet of Things
abstract: A disaster is a serious disruption of the functioning of a community or a society involving widespread human, material, economic or environmental loss and impacts, which exceeds the ability of the affected community or society to cope using its own resources. Researchers have been studying disasters for more than a century, and for more than forty years disaster research. When discussing disaster management, there are a few processes that form the links in the chain and work in tandem to complete the emergency management lifecycle. The process starts with identification of risks, disaster preparedness, emergency response, resources allocation, reaction planning, and lastly disaster recovery. Fortunately, iothas the solution to help the disaster management agencies at every stage of the process.

title: Tripodal molecular propellers perturb microtubule dynamics: indole acts as a blade and plays a crucial role in anticancer activity.
abstract: An indole rich tripodal microtubule inhibitor is designed, which binds at the DCVJ site of tubulin and inhibits its polymerization. It causes apoptotic death of cancer cells without affecting normal cells and inhibits the growth of tumors. Finally, STD NMR and TR NOESY experiments reveal that the indole appendages play a crucial role in interacting with tubulin.