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Rayappa C.,Apollo Speciality Hospital
Otorhinolaryngology Clinics | Year: 2011

Jugular foramen tumors are rare cranial base lesions that present diagnostic and management difficulties. Paragangliomas were the most frequent lesions, followed by schwannomas and meningiomas. These tumors have characteristic radiological features. Radical resection of these tumors with preservation of the lower cranial nerves is the treatment of choice. Despite the advances in skull base surgery, new postoperative lower cranial nerve deficits still represent a challenge.

Swaminathan K.,Apollo Speciality Hospital
Diabetic Medicine | Year: 2013

It is no exaggeration to claim that the 'diabetes epidemic' has become a 'runaway train' causing huge health and economic consequences, especially in the developing nations. Traditionally, the risk factors for diabetes have largely focused on genetics and lifestyle. Great emphasis is placed on lifestyle measures and finding novel pharmacological treatment options to combat diabetes, but there is increasing evidence linking environmental pollutants, especially pesticides, to the development of insulin resistance and Type 2 diabetes. Pesticide use has increased dramatically worldwide and the effects of pesticides on glucose metabolism are too significant for a possible diabetogenic link to be dismissed. The aim of this review article was to assess the links between pesticides and human diabetes with the goal of stimulating further research in this area. © 2013 The Author. Diabetic Medicine © 2013 Diabetes UK.

Swaminathan K.,Apollo Speciality Hospital
Journal of the Indian Medical Association | Year: 2012

There is an alarming rise in the prevalence of diabetes in India. The long term microvascular and macrovascular complications of diabetes, especially in a genetically susceptible population, can be devastating. There is strong evidence that better glycaemic control, especially early in the course of diabetes, can lead to significant reductions in both microvascular and macrovascular complications. There are various tools available to intensify glycaemic control in a safe manner. One such important tool is self monitoring of blood glucose (SMBG) using a hand held glucose meter. Unfortunately, SMBG is underutilised in India due to various factors. The aim of this article is to increase the awareness of SMBG, so that general physicians can use this tool in a logical manner to improve glycaemic control and thereby reduce long term complications in patients with diabetes.

Shi Y.,Peking Union Medical College | Au J.S.-K.,Queen Elizabeth Hospital | Thongprasert S.,Chiang Mai University | Srinivasan S.,Apollo Speciality Hospital | And 6 more authors.
Journal of Thoracic Oncology | Year: 2014

INTRODUCTION:: PIONEER (NCT01185314) was a prospective, multinational, epidemiological study of epidermal growth factor receptor (EGFR) mutations in patients from Asia with newly diagnosed advanced lung adenocarcinoma. METHODS:: Eligible patients (aged ≥20 years) had untreated stage IIIB/IV adenocarcinoma. The EGFR mutation status (primary end point: positive, negative, or undetermined) of tumor samples (biopsy, surgical specimen, or cytology) was determined (Scorpion amplification refractory mutation system). EGFR mutation frequency was calculated and compared between demographic and clinical subgroups. RESULTS:: Of 1482 patients from seven Asian regions, 43.4% of patients were female, median age was 60 years (range, 17-94), and 52.6% of patients were never-smokers. EGFR mutation status was evaluable in tumors from 1450 patients (97.8%) (746 [51.4%] positive; 704 [48.6%] negative). Country, sex, ethnicity, smoking status, pack-years (all p < 0.001), disease stage (p = 0.009), and histology type (p = 0.016) correlated significantly with EGFR mutation frequency. Mutation frequency was 61.1% in females, 44.0% in males; lower in patients from India (22.2%) compared with other areas (47.2%-64.2%); highest among never-smokers (60.7%); and decreased as pack-year number increased (>0-10 pack-years, 57.9%; >50 pack-years, 31.4%) (similar trend by sex). Ethnic group (p < 0.001) and pack-years (p < 0.001) had statistically significant associations with mutation frequency (multivariate analysis); sex was not significant when adjusted for smoking status. CONCLUSION:: PIONEER is the first prospective study to confirm high EGFR mutation frequency (51.4% overall) in tumors from Asian patients with adenocarcinoma. The observed high mutation frequency in demographic/clinical subgroups compared with white populations suggests that mutation testing should be considered for all patients with stage IIIB/IV adenocarcinoma, even males and regular smokers, among Asian populations. © 2013 by the International Association for the Study of Lung Cancer.

Kapoor N.,University of California at Los Angeles | Raj R.,Apollo Speciality Hospital
Indian Journal of Pediatrics | Year: 2016

Hematopoietic stem cell transplantation provides a curative option for children with primary immune deficiency disorders. Increased awareness and rapid diagnosis of these conditions has resulted in early referral and the chance to offer a curative option for affected children. Management of these children involves a multidisciplinary team including infectious disease specialists and intensivists. The use of reduced intensity conditioning chemotherapy, advances in detection and therapy of viral and fungal infections, optimal supportive care and techniques in stem cell processing, including T cell depletion has enabled doctors to transplant children with co-morbid conditions and no matched donors. Transplantation for these children has also brought in deep insights into the world of immunology and infectious diseases. © 2016 Dr. K C Chaudhuri Foundation

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