Case Studies - Ruby General Hospital, Kolkata

Dr Shomes Mazumder ( Consultant ENT, Head & Neck Surgeon  -  Ruby General Hospital ) A female senior citizen of 82 years had been presented with  ulceration  on a pre-existing  mole  on the right cheek and right post auricular area (Area around the ear) for the last 2 years and was admitted under the expert care of  Dr. Shomes Mozumder ( Consultant ENT, Head and Neck Surgery ) . After a thorough evaluation, relevant investigations were done including incision  biopsy  from both the  lesions  which revealed basal cell  carcinoma  (A type of  skin cancer  that begins in the basal cells). The lady had a history of hypertension, Type II Diabetes Mellitus, Hypothyroidism, and an old cerebrovascular accident. Before the surgery, the lady had been reviewed again for anemia, hypertension, and glycaemic control and she also received one unit of  Packed Red Blood Cells  (PRBC). The treating consultant had a d...

Dr. Dibyadip Mukhopadhyay ( Intensivist & Pain Physician  -  Ruby General Hospital ) A 51 year old man was admitted with complaints of an aggravating  chest pain  and a  chronic arm pain  for the past six months. The pain was so severe that he had great difficulty in mobilizing his shoulder or take  deep breaths . This was also associated with  eye sight issues . He was evaluated and relevant investigations were carried out. Opinions of Cardiologist and Orthopaedic consultants were taken and advice was duly followed. Orthopaedic consultants ruled out any  anatomical and surgical abnormalities . He was then referred to  Pain Clinic  and was subsequently diagnosed with  impingement syndrome  (A syndrome involving  tendonitis  i.e.  inflammation of the tendons ) and  Costochondritis  (It is an inflammation of the junctions where the upper ribs join with the cartilage that holds them to the breastb...

Dr Kumadip Banerjee ( Consultant General Physician  -  Ruby General Hospital ) The global pandemic has been taking a toll on innumerable lives worldwide and the senior citizens are more vulnerable as, generally, their immunity levels are pretty low. A 66-year-old senior citizen had been presented in the Emergency department with complaints of  fever  for 4 – 5 days and  flu  like presentation. He was a known case of Type 2  Diabetes  Mellitus (uncontrolled) and was not associated with shortness of breath and  respiratory symptoms . The gentleman had been admitted under the care of  Dr. Kumardip Banerjee (Consultant Medicine)  and after evaluation, relevant investigations were done. Unfortunately, he was diagnosed positive for  COVID 19   pneumonia  and his family members had been very anxious as they had heard that the mortality rate of senior citizens is high. Initially, the elderly man had been treated conservativel...

Dr Ajitesh Roy ( Chief of Endocrinology  -  Ruby General Hospital ) A 24 year old lady who had been suffering from  hypokalaemia  (low potassium level) had been admitted in  Ruby General Hospital  with a history of nausea and vomiting. The lady had been admitted in various hospitals for multiple occasions due to recurrent hypokalaemia and was treated with K+ supplements. She also suffered from  persistent hypertension . She was born out of a consanguineous marriage (marriage between two individuals who are related by blood) and had no history of perinatal (immediately before or after birth) or childhood crisis. Her developmental milestone was normal but, there was no feature of puberty for which she received a few courses of estrogen.  Other evaluation showed  persistent metabolic alkalosis , where the pH of tissue is elevated beyond the normal range (7.35 – 7.45). Radiological investigations revealed the absence of uterus and ovary. The pati...

Dr. Prerna Pallavi ( Consultant Gastroenterologist  -  Ruby General Hospital ) 33 years old lady, presented to her treating specialist after she suddenly developed  pain abdomen and jaundice  in last trimester of pregnancy. After initial evaluation she was diagnosed to have jaundice with gall stone disease and hence was taken up emergency caesarean section (outside). However post-surgery she continued to have jaundice with worsening pain abdomen and hence presented to us for further management.  At presentation she was conscious oriented, had  SIRS , mild respiratory distress and abdominal distention. Her covid status was positive with mild disease on HRCT, mixed pattern of jaundice, leukocytosis, b/l pleural effusion with necrotizing pancreatitis and evidence of gall stone disease with no biliary obstruction.   She was started on standard management protocol for covid and  pancreatitis  along with other supportive treatment. With a good nurs...

  Dr Tapas Ray ( Sr. Consultant General Medicine  -  Ruby General Hospital ) A 15-year-old girl had been admitted in  Ruby General Hospital  under the care of  Dr. Tapas Ray (Consultant Medicine)  with episodes of  tonic clonic seizures  (7 -8 times) the previous night. She had a history of low-grade fever for the past 3 years associated with swelling over right side of neck which gradually increased in size and weight loss. Excision biopsy of right axillary node had been done which revealed  Kikuchi’sLymphadentis . Kikuchi Fujimoto Disease (KFD) , is a rare self-limiting disorder that typically affects the cervical lymph nodes. Recognition of this condition is crucial, especially because it can easily be mistaken for tuberculosis or lymphoma. Mortality is extremely rare and usually due to hepatic, respiratory, or cardiac failure.  The girl was under medical management, but she suffered another episode of tonic clonic seizure which ...

  Dr. Sumanta Dey ( Advanced Laparoscopic, Bariatric & GI OncoSurgeon  -  Ruby General Hospital ) Mr. Kundu  was a free-spirited man, until one day he noticed a big lump in his belly. In this pandemic scenario, it was a double blow for him, when he came to know that he is having two large Hydatid Cysts capturing almost half of his liver. These are Parasitic Cysts containing tapeworm larvae, which grow in the body for years before symptoms appear. When cysts become large, they may cause nausea, weakness, coughing and stomach or chest pain. Hydatid disease is endemic in India. The annual incidence is varying, 1 to 200 per 100000 population. Mr. Kundu  & his family members were pretty afraid when they came to know he needs a major surgery to get rid of it. But they were convinced that the whole procedure can be done by  Advanced Laparoscopy  with prior optimization to minimize the suffering as much as possible. He underwent a major  Laparosco...

  Dr. Anirban Basu ( Consultant Paediatric & Neonatology  -  Ruby General Hospital )   A 13-year-old female girl had been admitted under the care of  Dr. Anirban Basu ( Consultant Paediatric )  with complaints of abdominal pain, fever and vomiting for the last seven days, along with decreased urine output for three days prior to admission. On admission the child was toxic, had multiple episodes of vomiting, decreased urine output, but was not in shock. She was evaluated and relevant blood and urine investigations were done. The Liver Function Test (LFT) and Renal Function Test (RFT) results were deranged. The creatinine level was high and CRP level was 372.4, while, there was presence of pus cells and RBC in the urine. The blood pressure was within normal range throughout, eventually, she was started on antibiotics which were adjusted as per renal dose as the creatinine level was high along with IV fluids bolus followed by maintenance of fluid, post whi...

  Dr. Snankhydip Pramanik (Sr. Consultant  CTVS  -  Ruby General Hospital )   A 30 year old young man had been presented with sudden onset of shortness of breath and recurrent fever for one month along with a history of Type II Diabetes mellitus. He had been admitted under the expert care of  Dr. Sankhadip Pramanik ( Cardiothoracic and Vascular Surgeon )  who clinically assessed him and relevant investigations were sent for. Due to the pandemic scenario investigation for COVID – 19 (RT –PCR) had also been advised which resulted negative. In addition two units of Packed Red Blood Cells (PRBC) had also been transfused. CT scan of chest had been done followed by  Bronchoscopy . After discussion with the family members and with informed consent the gentleman had been posted for surgery. Decortication of left lung had been done with the help of double lumen tube ( Endotracheal tube  designed to isolate the lungs anatomically and physiologically). ...

   Dr Kumar Gauraw ( Consultant Urologist  -  Ruby General Hospital ) A 62 year old gentlemen having  Diabetes ,  Hypertension  presented to us with symptoms of Blood in the urine. Upon investigation he was found to have a tumour in the  urinary bladder . Half an hour of completely painless micro-surgery without making a cut on the body which was done through  urinary passage  finally cured the disease. So early detection and proper micro-surgery in expert hand can lead to cancer free life.

U/Dr Prasanna AV ( Consultant Neurosurgeon - Ruby General Hospital ) We always consider home as the safest haven but, sometimes emergencies take place in the safest of places. Brain hemorrhage is a catastrophic event in any one’s life and it causes a lot of neurologic disabilities like disability and is a leading cause of death today. A 68-year-old professional singer had been presented with a history of fall at home resulting in total paralysis of right sided limbs (Hemiparesis) and was unable to speak. He was deteriorating rapidly and was admitted under the expert care of Dr. Prasanna AV (Senior Consultant Neuro Surgeon ) who thoroughly evaluated him and relevant investigations were sent for. The MRI revealed left sided subdural haematoma (A pool of blood between the brain and its outermost covering). The gentleman was a known case of Hypertension and Type II Diabetes Mellitus. After discussion with the family members and with informed written consent the gentleman was posted fo...

Dr. Raktim Guha (Consultant  Critical Care  -  Ruby General Hospital ) A gentleman of over 50 years had been presented in the Emergency Department of Ruby General Hospital with complaints of severe weakness for the last seven days along with fever and was admitted under the expert care of Dr. Raktim Guha (Consultant Critical Care ) . The gentleman was febrile initially and had dengue fever with uncomplicated course previously. On presentation he had severe body ache and rashes over the anterior part of the body and both upper limbs. Considering the pandemic scenario keeping in mind all the probabilities, a thorough evaluation had been done which revealed dengue fever and SARS-CoV-2 infection. The platelet count had been very low (22,000) with increased haemoglobin and P.C.V., so a close watch was kept on two parameters, hydration which was maintained properly with IV fluids, and coagulation profile as the liver function was deranged, which is very common in repeat deng...

Dr. Bikash Banerjee (HOD, Dept of Gynaecology & Obstetrics  -  Ruby General Hospital ) A 40-year-old lady presented with complaints of pain in the lower abdomen associated with heaviness and difficulty in passing urine. She had been admitted under the expert care of Dr. Bikash Banerjee (Senior Consultant Gynaecologist) . After clinical evaluation, relevant investigations had been done and the USG revealed broad ligament fibroid. Broad Ligament Fibroid , although rare, is a benign smooth muscle tumor which originates from the broad ligament hormone-sensitive smooth muscle or secondarily from the uterine smooth muscle. After discussion with the family members and with proper informed and written consent, the lady had been posted for surgery. Myomectomy and Adhesiolysis had been performed with a single incision on uterus. The fibroid sized at 10 cm X 10 cm had been removed laparoscopically using the morcellation which is a surgical technique used to reduce the size of the myo...