Varkey P.,Rochester College |
Murad M.H.,Rochester College |
Grall K.J.H.,University of Arizona |
Saoji V.,Bharati Vidyapeeth Medical College
Journal of Evaluation in Clinical Practice | Year: 2010
Objective Numerous studies performed over the last 30 years suggest that doctors have poor knowledge of the costs of medical care. In most graduate medical education programmes, trainees do not receive formal training in cost-effective medical practice. Methods Comprehensive literature search of electronic bibliographic databases for articles that describe health economics, cost-containment and cost-effectiveness curricula in graduate medical education. Critical appraisal of the literature and qualitative description is presented. Heterogeneity of curricula precluded quantitative summary of data. Results We identified 40 articles that met the inclusion criteria for this review. Internal medicine residents were the targeted learners in 27 studies (68%); Family Medicine and Surgery residents were each targeted in five studies (13%); Rehabilitation, Paediatrics and Emergency Medicine residents were each targeted in one study. In general, the methodological quality of the included studies was poor to moderate and mostly targeted knowledge of health economics or cost-containment as opposed to targeting cost-effectiveness. In terms of describing the standard curricular components, studies sufficiently described the different educational strategies (e.g. didactics, interactive, experiential, self-directed) and the component of learner assessment, but lacked the description of other elements such as needs assessment and curriculum evaluation. Conclusion Cost-effectiveness curricula in graduate medical education are lacking and clearly needed. © 2010 Blackwell Publishing Ltd.
Gaurav K.,Amrita Institute of Medical science |
Vilas J.,Bharati Vidyapeeth Medical College
International Journal of Lower Extremity Wounds | Year: 2010
Fixed flexion deformity (FFD) of the knee causes significant patient disability and is challenging to orthopedic surgeons because of its complexity. A prospective study was conducted using Ilizarovg's principles of distraction neohistogenesis and differential distraction and Ilizarovg's ring fixator for the correction of this deformity in cases with soft-tissue contracture. This was done without any concurrent bony procedures. A prospective, uncontrolled study of 26 patients (39 knees) was conducted over a 4-year period with prior approval from the local institutional review board. Patients with FFD of the knee without bony ankylosis were treated with knee-spanning 4-ring Ilizarovg's frame and gradual differential distraction. All patients showed complete correction of deformity without any significant complications. The results of this uncontrolled study permit the observation that soft-tissue distraction across a joint using Ilizarovg's principle results in soft-tissue lengthening and correction of joint deformity caused by contractures. This technique needs further detailed examination. © 2010 The Author(s).
Gandhi S.,Deenanath Mangeshkar Hospital |
Kulkarni S.,ENT consultant |
Mishra P.,Bharati Vidyapeeth Medical College |
Thekedar P.,Deenanath Mangeshkar Hospital
Indian Journal of Otolaryngology and Head and Neck Surgery | Year: 2012
Tuberculosis is the most frequent granulomatous disease involving larynx. In most cases it is secondary to pulmonary tuberculosis. Incidence of tuberculosis is now on a rise due to increase in incidence of immune deficiency states. Here we present a report of clinical characteristic of laryngeal tuberculosis based on our experience of 10 cases. A detailed retrospective analysis of 10 patients of laryngeal tuberculosis was done at our tertiary care laryngology centre. Majority of patients had change of voice and dry cough. All the patients had hyperemia and edema of vocal cords. 80% patients had involvement of the arytenoids and ary-epiglottic folds. Frank granulomatous growth was seen in 70% of patients. In all patients histopathological report was consistent with tubercular granuloma. Two patients had associated pulmonary tuberculosis. Eight patients did not reveal any feature suggestive of previous or co-existent pulmonary tuberculosis. All patients responded to chemotherapy with complete resolution. Primary laryngeal tuberculosis is not as rare as generally considered. This series provides an insight towards clinical feature, growth pattern and management of tuberculosis of larynx. © 2011 Association of Otolaryngologists of India.
Gandhi S.,Deenanath Mangeshkar Hospital and Research Center |
Remacle M.,University Hospital of Leuven |
Mishra P.,Bharati Vidyapeeth Medical College |
Desai V.,Deenanath Mangeshkar Hospital and Research Center
European Archives of Oto-Rhino-Laryngology | Year: 2014
Spasmodic dysphonia (SD) remains one of the most difficult of laryngeal pathologies to treat. With limited role for speech therapy, various surgical modalities have been tried with various success rates. The objective of the study is to report the results of vocal outcome after thyroarytenoid myoneurectomy in patients of adductor spasmodic dysphonia (ASD). 15 patients of ASD were selected. GRBAS, and voice handicap index (VHI) were used for perceptual evaluation of voice. Thyroarytenoid myoneurectomy was performed by vaporizing the muscular layer of the vocal fold with CO2 laser, at an intensity of 6 W with 1.2 mm diameter in scanner mode. Voice analysis was repeated at 12, 24 and 48 months follow-up. Preoperative GRBAS scores and VHI score of all the patients were poor. At 12 months 12/15 (80 %) patients having strain score of 0. There was marked improvement in VHI scores at 6 months. 10/15 (67 %) patients have been followed up for 24 months. 5/10 (50 %) patients have strain (S) value of 0. VHI scoring of 5/10 (50 %) patients was <30. Two of the four patients completed 48 months follow-up had a strain (S) value of 0, one patient has strain value of 1 and one patient had strain value of 2. 2/4 patients had VHI score of <30; one patient had that of 40. Trans-oral CO2 laser thyroarytenoid myoneurectomy shows significant long-term improvement in voice quality in terms of reduced speech brakes, effort and strain in voice. © 2014, Springer-Verlag Berlin Heidelberg.
Nagpal S.,Bharati Vidyapeeth Medical College |
Kulkarni V.,Bharati Vidyapeeth Medical College
Journal of Clinical and Diagnostic Research | Year: 2016
Dirofilariasis is a zoonotic disease caused commonly by Dirofilaria repens and Dirofilaria immitus. The definitive hosts are domestic dogs and cats. Human beings are accidental dead end hosts, and acquire infestation through mosquito bites. So far, very few cases have been reported from western India. We report a case of a 27-year-old male who presented with preseptal cellulitis right eye and a firm mass in the lower lid. Histopathological examination after surgical excision of the mass revealed a diagnosis of dirofilariasis. Although rare in Western India a diagnosis of dirofilariasis should be considered in cases of preseptal cellulitis associated with a periorbital mass. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved.
Dawane J.S.,Bharati Vidyapeeth Medical College |
Pandit V.A.,Bharati Vidyapeeth Medical College
Journal of Clinical and Diagnostic Research | Year: 2012
When a cell is damaged or altered without repair to its system, it usually dies. But if such damaged or unrepaired cells do not die and proliferate with uncontrolled growth; a mass of cancer cells develop. Cancer has a complex aetiology with multiple risk factors that involve the interplay between genetic and environmental influences. The redox dysregulation originates from metabolic alterations and it is dependent on mitogenic and survival signalling through reactive oxygen species. There is a delicate balance between the production and the destruction of reactive species; for this, we need to understand the role of redox homeostasis in cancer. So, the specific vulnerability of the malignant cells can be selectively targeted. This article will outline the redox homeostasis and the relationship between the disturbances in it and cancer.
Sardesai V.R.,Bharati Vidyapeeth Medical College |
Kolte J.N.,Bharati Vidyapeeth Medical College |
Srinivas B.N.,Bharati Vidyapeeth Medical College
Indian Journal of Dermatology | Year: 2013
Background: Melasma is a common acquired facial hypermelanosis. Conventional treatment of melasma includes a sunscreen and hypopigmenting agents. The treatment of this recalcitrant disorder is often difficult and unsatisfactory. Aims: The objective is to carry out a detailed clinical study of melasma and to assess the therapeutic effect and side effects of certain currently available topical modalities for the treatment of melasma. Materials and Methods: 160 patients of all age groups and both sexes were treated sequentially with five different combination regimes for 3 months. Assessment of the response was done subjectively as well as by melasma area and severity index (MASI). Results: Out of the five modalities studied, the modified Kligman's formula was the most effective. However, it had comparatively higher incidence of side effects. Conclusions: Among the currently available topical modalities for the treatment of melasma, the most effective combination is the modified Kligman's formula. However, in view of the side effects it causes, it must be used with caution and proper counseling. © Indian Journal of Dermatology 2013.
Karandikar M.,Bharati Vidyapeeth Medical College
The Indian journal of chest diseases & allied sciences | Year: 2011
Thymoma is a very rare tumour arising from thymus in the anterior mediastinum. A case of a spindle cell thymoma with Myasthenia gravis in a 34-year-old female who presented with difficulty in breathing and swallowing with shortness of breath is reported.
Patankar S.S.,Bharati Vidyapeeth Medical College |
Chandorkar S.S.,Bharati Vidyapeeth Medical College |
Garg A.,Bharati Vidyapeeth Medical College
Indian Journal of Surgery | Year: 2012
Tuberculosis of the major salivary gland is a rare entity. Only 100 cases have been reported so far in world literature, mostly in post parotidectomy specimens. Here we are reporting a case of tuberculosis of parotid gland diagnosed on histological evaluation after surgery. © 2011 Association of Surgeons of India.
Mutalik M.,SSR Medical College |
Mutalik M.,Bharati Vidyapeeth Medical College
Australian Journal of Medical Herbalism | Year: 2011
Tinospora cordifolia is known as an adaptogen or rejuvenator and is traditionally used in Ayurvedic medicine. It has immunomodulatory, antioxidant, antihyperglycemic, anti-infl ammatory, antiulcer, antispasmodic and other properties. Recent evidence from animal and human studies underscores the potential antistress properties of Tinospora cordifolia. The antistress action has been shown to be benefi cial in depression and in improving cognition and memory. The most likely antidepressant mechanisms involve inhibiting reuptake of amines in the brain. Improved levels of norepinephrine (NE), serotonin (5-hydroxytryptamine or 5-HT), and dopamine (DA), and decreased levels of gamma-aminobutyric acid (GABA) have been demonstrated. Inhibiting the breakdown of amines, particularly norepinehphrine and serotonin has also been demonstrated. GABA-B receptor antagonism and G-protein mediated signallling have been suggested as additional underlying mechanisms. Central antioxidant and protective properties play an important role in improving cognition, concentration and memory. Tinospora cordifolia has also been shown to be benefi cial in improving cerebral ischemia. Prevention of oxidative stress injury and regulation of cytokines are possible mechanisms involved in these benefi cial effects. Tinospora cordifolia works synergistically with many herbal preparations, which makes it an important component of polyherbal formulations. Lack of evidence for serious toxicity presents Tinospora cordifolia as one of the unique herbal medicines in management of depression, Alzheimer's disease and attention defi cit hyperactivity disorder. Further work on elucidation of mechanisms, selectivity of action and drug interactions with other herbal substances will be helpful in determining the current status of Tinospora cordifolia as a psychopharmacological agent. © National Herbalists Association of Australia 2011.