Armed Forces Medical College

Pune, India

Armed Forces Medical College

Pune, India
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Mehrotra S.,Armed Forces Medical College
Annals of Plastic Surgery | Year: 2017

INTRODUCTION: Faciomaxillary fractures (FMF) occur in a significant proportion of trauma patients. Nearly all polytrauma patients and even those with isolated FMF are managed under general anesthesia for definitive management. We propose the use of regional nerve blocks as a safe and effective means for open reduction and fixation of isolated FMF. AIM AND OBJECTIVES: The aim is to evaluate the feasibility, effectiveness and safety of base of skull maxillomandibular and distal trigeminal nerve blocks in the management of FMF. MATERIALS AND METHODS: Ten young adults with fractures of the zygoma, mandible and Le Fort I/II injuries were included in the study. Patients with associated craniocervical and abdominothoracic injuries were excluded. RESULTS: The patients’ ages ranged from 21 to 40 years, with a mean time of onset of anesthesia being 5 to 12 minutes and total duration of 105 to 220 minutes. Supplementary block for patchy anesthesia was needed in three. All underwent unhindered surgery without complication. CONCLUSION: Base of skull maxillary-mandibular and distal trigeminal blocks are an effective and efficient alternative to general anesthesia for the open reduction and internal fixation of FMF. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

The International Association of HealthCare Professionals is pleased to welcome Arup Maitra, MD, Nephrologist, to their prestigious organization with his upcoming publication in The Leading Physicians of the World. Dr. Maitra is a highly-trained and qualified Nephrologist with an extensive expertise in all facets of his work, especially internal medicine and nephrology. He has been in practice for more than 20 years and is currently serving patients at Renal Consultants Inc. in Canton, Ohio. Furthermore, Dr. Maitra is affiliated with Aultman Hospital, Mercy Medical Center, Union Hospital, and Affinity Medical Center. Dr. Arup Maitra’s career in medicine began in 1982 when he graduated his Medical Degree from the Armed Forces Medical College of the University of Pune in India. After moving to the United States, Dr. Maitra completed his internship at the Lincoln Hospital, followed by his residency at New York Medical College. Dr. Maitra is certified in Nephrology by the American Board of Internal Medicine, and has also earned the coveted title of Fellow of the American College of Physicians. In addition to his busy practice, Dr. Maitra serves as a Clinical Assistant Professor at Northeast Ohio Medical University. He attributes his great success in his field to his compassion for his patients, as well as his commitment to providing them with the best treatment available. When he is not assisting patients, Dr. Maitra likes to relax by reading. Learn more about Dr. Maitra by reading his upcoming publication in the Leading Physicians of the World. is a hub for all things medicine, featuring detailed descriptions of medical professionals across all areas of expertise, and information on thousands of healthcare topics.  Each month, millions of patients use FindaTopDoc to find a doctor nearby and instantly book an appointment online or create a review. features each doctor’s full professional biography highlighting their achievements, experience, patient reviews and areas of expertise.  A leading provider of valuable health information that helps empower patient and doctor alike, FindaTopDoc enables readers to live a happier and healthier life.  For more information about FindaTopDoc, visit

BACKGROUND:: Propranolol has emerged as front-line therapy for infantile hemangiomas (IHs). However, a well-defined protocol for administering and predicting response to propranolol is unavailable. METHODS:: In this open-label trial, 31 children with IH (median age=5 mo; range,1 mo to 9 y) were administered propranolol (2 mg/kg/d) for a median duration of 28 weeks (12 to 50 wk). They were compared with 14 historical controls with IH who did not receive any treatment. An image-based scoring system was used to assess involution. RESULTS:: Propranolol (28/31, 90.3%) produced better and faster response compared with control treatment (4/14, 28.6%). With propranolol, 65% to 80% involution was obtained in the first 8 weeks, with an additional 2% to 10% involution until 20 weeks. After 20 weeks, the changes in IH were insignificant. Response was more pronounced among infants ≤6 months of age who attained a peak involution score of 1.86, suggesting >80% involution of IH. The similar score in the cohort aged 6 to 36 months was 3.31. The heart rate (HR) decline after propranolol treatment was significantly higher among patients whose hemangioma responded to propranolol than in those who did not respond (P=0.0006). Decline in HR by >20%, 2 weeks after propranolol administration, was predictive of IH involution (relative risk=0.11; 95% confidence interval, 0.02-0.51; P=0.036). CONCLUSIONS:: Propranolol is efficacious in patients with IH. The most pronounced response is seen in the first 8 weeks and in infants aged 6 months or younger. A decline in HR >20% is an early marker of response to propranolol. Copyright © 2013 by Lippincott Williams & Wilkins.

Goyal R.,Armed Forces Medical College | Shukla R.N.,Armed Forces Medical College | Kumar G.,Armed Forces Medical College
Paediatric Anaesthesia | Year: 2012

Background: We compared size 2 i-gel® (Intersurgical Inc.), a relatively new supraglottic airway device for use in spontaneously breathing anesthesized children with two different types of laryngeal mask airway-ProSeal™ laryngeal mask airway (PLMA) and Classic™ laryngeal mask airway (cLMA) for the ease of insertion, oropharyngeal sealing pressures (OSPs), and air leak. The hemodynamic effects on insertion of device and postoperative adverse effects were also noted. Methods: A randomized prospective study was planned in 120 children aged 2-5 years, weighing 10-20 kg, ASA physical status I-II scheduled for routine elective surgeries of <1-h duration. They were randomly divided in three groups (i-gel, PLMA, and cLMA) of 40 each, and a standard protocol for anesthesia was followed. Results: The age, weight, height, and type of surgery were similar in all groups. Success rate for first attempt was 95% for the i-gel group and 90% for the two laryngeal mask airway groups. Insertion was found to be easy in the majority of cases in all groups, and there was no change in blood pressure, heart rate, or oxygen saturation on insertion. The OSP was 26 ± 2.6, 23 ± 1.2, and 22 ± 2.3 cm H 2O for i-gel, PLMA, and cLMA, respectively. The difference between the i-gel and both laryngeal mask airway groups was statistically significant (P < 0.01). There were no clinically important complications in the postoperative period. Conclusion: Pediatric size 2 i-gel is easy to insert and provides higher OSP compared with same size PLMA and cLMA in spontaneously breathing children undergoing elective surgery. It may be a safe alternative to laryngeal mask airways in day care surgeries. © 2011 Blackwell Publishing Ltd.

Sati A.,Armed Forces Medical College
Cornea | Year: 2016

PURPOSE:: To evaluate the corneal endothelial changes in patients with chronic renal failure. METHODS:: A total of 128 corneas of 128 subjects were studied, and 3 groups were formed. The first, the dialyzed group, composed of 32 corneas of 32 patients; the second, the nondialyzed group, composed of 34 corneas of 34 patients; and the third, the age-matched control group, composed of 64 corneas of 64 healthy subjects were examined by a specular microscope and the endothelial parameters were compared. The dialyzed group (enhanced level of toxins in the blood) was further analyzed to assess the influence of blood urea, serum creatinine, serum calcium, and serum phosphorus including the duration of dialysis on corneal endothelium. RESULTS:: On comparing the 3 groups using analysis of variance and posthoc tests, a significant difference was found in the central corneal thickness (CCT) and endothelial cell density (CD) between the control (CCT: 506 ± 29 μm, CD: 2760 ± 304 cells/mm) and dialyzed groups (CCT: 549 ± 30 μm, CD: 2337 ± 324 cells/mm) [P < 0.001 (CCT); P < 0.001 (CD)]; control and nondialyzed groups (CCT: 524 ± 27 μm, CD: 2574 ± 260 cells/mm) [P = 0.023 (CCT); P = 0.016 (CD)]; and dialyzed and nondialyzed groups [P = 0.002 (CCT); P = 0.007 (CD)]. Using the linear generalized model, a significant correlation was found between the endothelial parameters and blood urea only [P = 0.006 (CCT), 0.002 (coefficient of variation), 0.022 (CD), and 0.026 (percentage of hexagonality)], although the correlation was poorly positive for CCT but poorly negative for the remaining endothelial parameters. CONCLUSIONS:: Corneal endothelial alteration is present in patients with chronic renal failure, more marked in patients undergoing hemodialysis and with raised blood urea level. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.

Jindal A.K.,Armed Forces Medical College
Indian journal of public health | Year: 2014

Universal health coverage (UHC) is the means to provide accessible and appropriate health services to all citizens without financial hardships. India, an emerging economy with demographic window of opportunity has been facing dual burden of diseases in midst of multiple transitions. Health situation in the country despite quantum improvements in recent past has enormous challenges with urban-rural and interstate differentials. Successful national programs exists, but lack ability to provide and sustain UHC. Achieving UHC require sustained mechanisms for health financing and to provide financial protection through national health packages. There is a need to ensure universal access to medicines, vaccines and emerging technologies along with development of Human Resources for Health (HRH). Health service, management, and institutional reforms are required along with enhanced focus on social determinants of health and citizen engagement. UHC is the way for providing health assurance and enlarging scope of primary health care to nook and corners of the country.

Behera V.,Armed Forces Medical College
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2014

Emphysematous pyelonephritis (EPN) is a group of potentially life-threatening conditions seen particularly in diabetics, leading to high morbidity and mortality. Our aim was to study the profile of emphysematous infections of the kidney and urinary tract and evaluate the effect of early surgical intervention on mortality. This is an observational study conducted in a tertiary care hospital between January 2009 and January 2013, in which the clinical, laboratory, microbiological and radiological profiles of patients with EPN (diagnosed based on clinical, laboratory and imaging findings) was studied. A total of 12 patients were studied, including 10 with diabetes. A total of 66.6% had pyelonephritis, 25% had both cystitis and pyelonephritis and 8.3% had only cystitis; involvement of the left kidney was more common and bilateral involvement was seen in two cases. The clinical features seen in the patients included fever (100%), features of urinary infection (66.6%) and flank pain (50%). Culture positivity was seen in only 50% of the cases. Ten patients underwent percutaneous drainage (PCD) within 24 h, and two of these patients required nephrectomy subsequently. All patients were followed-up for one month. There was one death (mortality 8.3%), and all other patients responded well and recovered. Our study suggests that EPN is a potentially life-threatening condition that requires aggressive and prompt medical therapy with early PCD to reduce morbidity and mortality. Nephrectomy should be reserved for cases that do not respond to PCD.

Das A.K.,Armed Forces Medical College
Medical Journal Armed Forces India | Year: 2016

Reviewers play a vital role in ensuring quality control of scientific manuscripts published in any journal. The traditional double blind peer review, although a time-tested method, has come under increasing criticism in the face of emerging trends in the review process with the primary concern being the delays in completion of the review process. Other issues are the inability to detect errors/fraud, lack of transparency, lack of reliability, potential for bias, potential for unethical practices, lack of objectivity, inconsistencies amongst reviewers, lack of recognition and motivation of reviewers. Alternative options to classical peer review being propagated are: open review, immediate self-publication using preprint servers, nonselective review focusing primarily on the scientific content, and post-publication review. These alternative review processes, however, may suffer from the inability to validate quality control. In addition, anecdotal instances of peer review frauds are being reported more often than earlier. Suggested means to ensure quality of peer review process includes:(a) each journal to have its own database of reviewers, (b) verification of email IDs of reviewers provided by authors along with details of their institutions, (c) ensure credibility of reviewers before requesting for review, (d) check for plagiarism at the editorial level, (e) editors to distinguish between a good review from a possible biased/bad review, and (f) give recognition for reviewers once in a year. To conclude, quickness of review and publication should not dictate the scientific publication process at the cost of quality of contents. © 2016 Published by Elsevier B.V. on behalf of Director General, Armed Forces Medical Services.

Debnath J.,Armed Forces Medical College
Medical Journal Armed Forces India | Year: 2016

Plagiarism is one of the most serious forms of scientific misconduct prevalent today and is an important reason for significant proportion of rejection of manuscripts and retraction of published articles. It is time for the medical fraternity to unanimously adopt a 'zero tolerance' policy towards this menace. While responsibility for ensuring a plagiarism-free manuscript primarily lies with the authors, editors cannot absolve themselves of their accountability. The only way to write a plagiarism-free manuscript for an author is to write an article in his/her own words, literally and figuratively. This article discusses various types of plagiarism, reasons for increasingly reported instances of plagiarism, pros and cons of use of plagiarism detection tools for detecting plagiarism and role of authors and editors in preventing/avoiding plagiarism in a submitted manuscript. Regular usage of professional plagiarism detection tools for similarity checks with critical interpretation by the editorial team at the pre-review stage will certainly help in reducing the menace of plagiarism in submitted manuscripts. © 2016 Published by Elsevier B.V. on behalf of Director General, Armed Forces Medical Services.

Goyal R.,Armed Forces Medical College
Journal of Anaesthesiology Clinical Pharmacology | Year: 2015

Almost all supraglottic airways (SGAs) are now available in pediatric sizes. The availability of these smaller sizes, especially in the last five years has brought a marked change in the whole approach to airway management in children. SGAs are now used for laparoscopic surgeries, head and neck surgeries, remote anesthesia; and for ventilation during resuscitation. A large number of reports have described the use of SGAs in difficult airway situations, either as a primary or a rescue airway. Despite this expanded usage, there remains little evidence to support its usage in prolonged surgeries and in the intensive care unit. This article presents an overview of the current options available, suitability of one over the other and reviews the published data relating to each device. In this review, the author also addresses some of the general concerns regarding the use of SGAs and explores newer roles of their use in children.

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