Bj Government Medical College

Pune, India

Bj Government Medical College

Pune, India
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Prasad H.B.,Dr Vm Government Medical College | Borse R.T.,RCSM Government Medical College | Avate A.N.,Bj Government Medical College | Palasdeokar N.,Bj Government Medical College
Journal of Association of Physicians of India | Year: 2017

Introduction: Plasmapheresis is an important modality for the treatment of GBS. Moreover the response to this treatment modality is not same in all cases. We therefore studied the various prognostic indicators of response to plasmapheresis in patients of Guillain Barre Syndrome. Materials and Methods: 40 patients were included in the study. Thorough clinical examination was done. Nerve conduction was done to find out the type of neuropathy. All were then given plasmapheresis. Prognostic indicators with reference to Age, sex, presenting severity, time between onset of illness and arrival to hospital, time taken to start plasmapheresis, number of plasmapheresis cycles, respiratory involvement, and type of neuropathy were studied. Results: There were 57.5% females and 47.5% males. Majority (82%) patients were in the age group of 20 to 60 years. All the patients had power grade 1 or 2 on admission but on discharge the power was grade 3 to 5 in 29 (80.55%) patients. The number of patients who received 5 cycles was 34(85%) and those who received 4 cycles of plasmapheresis was 6(15%). AIDP (acute inflammatory demyelinating polyneuropathy) was seen in 36 (90%) pts and AMAN (Acute Motor axonal Neuropathy) was seen in 4 (10%) patients. The severity at presentation and improvement was similar for all ages. Those who received plasmapheresis late showed power improvement of 2 to 3 grade in (50%) whereas those who received early showed improvement of 2 or 3 grade power in 82.14% patients indicating better improvement with early plasmapheresis. No difference was seen in grade of power improvement in 4 or 5 cycles of plasmapheresis. The number of patients on mechanical ventilation were 13 (40.62%) AIDP cases and 4 (100%) AMAN cases indicating more respiratory involvement in AMAN patients. All four patients of AMAN put on mechanical ventilation died of Ventilator associated pneumonia. Conclusion: Early treatment with plasmapheresis has better outcome in patients of GBS.four and five cycles of plasmapheresis are equally beneficial. © 2017, Journal of the Association of Physicians of India. All rights reserved.


Kasbekar P.U.,Bj Government Medical College | Goel P.,Indian Institute of Science | Jadhav S.P.,Bj Government Medical College
Frontiers in Endocrinology | Year: 2017

Aim: The aim of this study is to create an evidence-based tool that guides the risk of amputation in diabetic foot patients. Materials and methods: Hospital records of 301 diabetic foot patients were examined retrospectively for explanatory variables of foot amputation decisions. The study included all patients with a lower limb ulcer with a known history of diabetes mellitus or those diagnosed post-admission. The dataset was analyzed, and a risk scoring system was constructed using the decision tree algorithm, C5.0. Two classifiers, one simple and another complex, were constructed for predicting amputation outcome. Results and discussion: Based on our evaluation, the most influential predictors for a decision to amputate are Doppler flow measurements and the Wagner grading of the ulceration. The simple classifier uses just these two parameters in determining risk. The results obtained show an accuracy of 96.4% in the primary group and an accuracy of 94% in the test group. The second classifier is a more complex computer-derived construct that showed 100% accuracy in the principle group and an accuracy of 96% during testing. Conclusion: In the present era of precision medicine, these two classifiers act as an accurate guide to the prognosis of the limb in patients with diabetic foot and can predict the risk of future amputation. © 2017 Kasbekar, Goel and Jadhav.


Tiwari S.A.,Bj Government Medical College | Ghongane B.B.,Bj Government Medical College | Daswani B.R.,Bj Government Medical College | Dabhade S.S.,Bj Government Medical College
Journal of Clinical and Diagnostic Research | Year: 2017

Introduction: The indoor hospital use of antibiotic irrationally has been a growing concern in the recent past. For the patients and providers of health care services this kind of drug consumption account for a major chunk of the budget. Aim: To assess the outcome of restriction on the use of parenteral antibiotics with respect to their utilization and monetary benefits, in a tertiary care hospital in India. Materials and Methods: Data details were collected regarding drug utilization two months before and after restriction respectively. A total 1605 patient records assessed. Drug utilization was expressed as DDD/100 patient bed days. Use of Carbapenems were restricted to culture positive cases only. Antibiotics started for patients as per clinical judgment were issued for only five days. Culture sensitivity reports verified physically on a special indent form, before every antibiotic issued thereafter. Results: Piperacillin-tazobactum (DDD/100 BD 1.72 before and 1.29 after restrictions) was the commonly used antibiotic. Considering values expressed in DDD/100 BD before and after restriction respectively, substantial decrease in consumption of antibiotics like Imipenem-Cilastin (0.22 to 0.16), meropenem (0.30 to 0.09), piperacillin-tazobactum (1.72 to 1.29), teicoplanin (0.24 to 0.05) and vancomycin (0.69 to 0.40) was observed. An increase in consumption of amoxicillin-clavulanic acid (0.90 to 1.04) and clarithromycin (0.44 to 0.55) noted, pointing to a shift in antibiotic use. Restriction decreased expenditure burden on these antibiotics by INR 1,45,911 (17.31 %). Conclusion: Restriction of antibiotics cuts down consumption and benefits hospital budget immensely. © 2017, Journal of Clinical and Diagnostic Research. All rights reserved.


Dhar M.H.,Bj Government Medical College | Shah K.U.,Grant Government Medical College | Ghongane B.B.,Bj Government Medical College | Rane S.R.,Bj Government Medical College
International Journal of Pharma and Bio Sciences | Year: 2013

Gentamicin and Ceftazidime are commonly used antibiotics, but their use is limited by potential nephrotoxicity. In the present study, the nephroprotective activity of Crocus sativus was evaluated against Gentamicin and/or Ceftazidime-induced renal toxicity. Ethanolic extract of stigmas of Crocus sativus was administered (i.p.) once daily to albino rats 30 min. before administration of Gentamicin or Ceftazidime (i.m.) alone and in combination for 10 days. Nephrotoxicity was assessed by estimation of biochemical parameters, 24 hrs urine output, urinalysis, Erythrocyte Sedimentation Rate (ESR), body and kidney weights; and kidney histopathology were evaluated. Extract alone had no significant effect. In gentamicin-treated rats, body weights and urine output were significantly lower than control rats; along with marked proteinuria, significant increase in blood urea, serum creatinine, ESR and kidney weights with changes in serum electrolytes. This nephrotoxicity was confirmed by histopathology. Ceftazidime induced similar but lesser damage. Their combination induced toxicity greater than individual drugs. These changes were prevented by the extract of Crocus sativus - a promising nephroprotective agent.


Walujkar S.A.,National Center for Cell Science | Walujkar S.A.,Bj Government Medical College | Dhotre D.P.,National Center for Cell Science | Marathe N.P.,National Center for Cell Science | And 3 more authors.
Gut Pathogens | Year: 2014

Background: The healthy human intestine is represented by the presence of bacterial communities predominantly belonging to obligate anaerobes; however disparity and dysanaerobiosis in intestinal microflora may lead to the progression of ulcerative colitis (UC). The foremost aim of this study is to consider and compare the gut microbiota composition in patients suffering from different stages of UC. Methods. This study represents data from the biopsy samples of six individuals suffering from UC. The samples were collected by colonoscopy and were processed immediately for isolation of DNA. Mucosal microbiota was analyzed by means of 16S rRNA gene-based Illumina high throughput sequencing. Quantitative real-time PCR (qPCR) was performed to determine total bacterial abundances. Results: Analysis of 23,927 OTUs demonstrated a significant reduction of bacterial diversity consistently from phylum to species level (p < 0.05) for individuals suffering from severe stage of UC. Significant increase in abundance of unusual aerobes and facultative anaerobes, including members from the phylum Proteobacteria (p- = 0.031) was also observed. A 10 fold increase in the total bacterial count was detected in patients suffering from severe inflammatory stage (2.98 +/-0.49 E + 09/ml) when compared with patients with moderate (1.03+/-0.29 E + 08/ml) and mild (1.76 +/-0.34 E + 08/ml) stages of inflammation. Conclusion: The reduction of bacterial diversity with an increase in the total bacterial count indicates a shift of bacterial communities which signifies dysbiosis and dysanaerobiosis at the mucosal level for patients suffering from UC. © 2014 Walujkar et al.; licensee BioMed Central Ltd.


Madhuri K.,Bj Government Medical College | Deshpande S.,Bj Government Medical College | Dharmashale S.,Bj Government Medical College | Bharadwaj R.,Bj Government Medical College
Journal of Global Infectious Diseases | Year: 2015

Background: Despite endorsement of the line probe assay (LPA) for the diagnosis of drug-resistant pulmonary tuberculosis patients, there is limited data available on the performance of LPAs in India, especially from high burden states like Maharashtra, for the early diagnosis and detection of drug resistance, in order to initiate timely and appropriate treatment. Objective: To evaluate the utility of the line probe assay (LPA) for the early diagnosis of drug-resistant pulmonary tuberculosis as compared to the 'Gold standard' 1% proportion method (PM). Materials and Methods: A total of 687 patients suspected of pulmonary tuberculosis were screened. One hundred samples (95 sputum and 5 BAL), positive for Acid Fast Bacilli (AFB) by Ziehl Neelson (ZN) smears, were included in the study. Digested and decontaminated specimens were subjected directly to the LPA (Genotype MTBDR@ plus assay) and were processed in parallel using the conventional culture on the Lowenstein-Jensen (LJ) medium followed by drug susceptibility testing (DST) using the PM. Results: All the 100 samples gave interpretable results on LPA with a turnaround time of 24-48 hours as opposed to six to eight weeks taken by the 1% proportion method. Sensitivity for the detection of rifampicin, isoniazid, and multidrug resistance (MDR) was 98.1, 92.1, and 95%, respectively, with a specificity of 97.8% for rifampicin and 98.33% for MDR detection. It also had the additional advantage of allowing a study of mutation patterns. Conclusions: High performance characteristics and a short turnaround time makes LPA an excellent diagnostic tool, for an early and accurate diagnosis, in a high MDR- TB-prevalent region, as reflected from our data.


Bhosale M.,BJ Government Medical College | Singh D.,BJ Government Medical College
Journal of Indian Association of Pediatric Surgeons | Year: 2016

A 3-day-old male neonate delivered at 34 weeks of gestational age was brought with breathing difficulty since birth. The abdomen was massively distended. A soft cystic mass was occupying almost the entire abdomen and causing obvious respiratory distress. On exploration, a huge, solitary, unilocular cyst was found between the two lobes of the liver. Growing extrahepatically between the two lobes, it had displaced them laterally on either side. Enucleation of the cyst and marsupialization of its base was done. Histopathology showed evidence of congenital solitary nonparasitic cyst of the liver. Symptomatic presentation of CSNCL in children, especially in a neonate is extremely rare and not considered as a differential diagnosis of an abdominal mass. Hence, the case report.


Kulkarni A.A.,Bj Government Medical College | Thakur S.S.,Bj Government Medical College
Journal of Clinical and Diagnostic Research | Year: 2015

Malignant tumours of the submandibular salivary glands are rare entities. Most common malignant tumour of submandibular gland is mucoepidermoid carcinoma. Histological finding of squamous cell carcinoma is very rare in submandibular salivary gland. Metastasis from distant primary squamous malignancy, direct invasion from cutaneous or mucosal squamous carcinoma, squamous component of mucoepidermoid carcinoma or primary squamous cell carcinoma of salivary origin are some of the possible causes. Of these, the latter is distinctly uncommon. Primary squamous malignancy is diagnosed only after ruling out other possible explanations. A positive mucin stain in the tumour or synchronous/ metachronous squamous carcinoma elsewhere excludes the diagnosis of a primary carcinoma. Primary squamous carcinoma is seen most commonly in parotid gland and rarely in submandibular gland. We present a case of primary squamous cell carcinoma of right submandibular salivary gland in a 45-year old-man. This case is presented for the rare entity of primary squamous cell carcinoma in submandibular salivary gland. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.


PubMed | Bj Government Medical College
Type: Journal Article | Journal: Journal of global infectious diseases | Year: 2015

Despite endorsement of the line probe assay (LPA) for the diagnosis of drug-resistant pulmonary tuberculosis patients, there is limited data available on the performance of LPAs in India, especially from high burden states like Maharashtra, for the early diagnosis and detection of drug resistance, in order to initiate timely and appropriate treatment.To evaluate the utility of the line probe assay (LPA) for the early diagnosis of drug-resistant pulmonary tuberculosis as compared to the Gold standard 1% proportion method (PM).A total of 687 patients suspected of pulmonary tuberculosis were screened. One hundred samples (95 sputum and 5 BAL), positive for Acid Fast Bacilli (AFB) by Ziehl Neelson (ZN) smears, were included in the study. Digested and decontaminated specimens were subjected directly to the LPA (Genotype MTBDR@ plus assay) and were processed in parallel using the conventional culture on the Lowenstein-Jensen (LJ) medium followed by drug susceptibility testing (DST) using the PM.All the 100 samples gave interpretable results on LPA with a turnaround time of 24-48 hours as opposed to six to eight weeks taken by the 1% proportion method. Sensitivity for the detection of rifampicin, isoniazid, and multidrug resistance (MDR) was 98.1, 92.1, and 95%, respectively, with a specificity of 97.8% for rifampicin and 98.33% for MDR detection. It also had the additional advantage of allowing a study of mutation patterns.High performance characteristics and a short turnaround time makes LPA an excellent diagnostic tool, for an early and accurate diagnosis, in a high MDR- TB-prevalent region, as reflected from our data.


PubMed | Bj Government Medical College
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2015

Malignant tumours of the submandibular salivary glands are rare entities. Most common malignant tumour of submandibular gland is mucoepidermoid carcinoma. Histological finding of squamous cell carcinoma is very rare in submandibular salivary gland. Metastasis from distant primary squamous malignancy, direct invasion from cutaneous or mucosal squamous carcinoma, squamous component of mucoepidermoid carcinoma or primary squamous cell carcinoma of salivary origin are some of the possible causes. Of these, the latter is distinctly uncommon. Primary squamous malignancy is diagnosed only after ruling out other possible explanations. A positive mucin stain in the tumour or synchronous/ metachronous squamous carcinoma elsewhere excludes the diagnosis of a primary carcinoma. Primary squamous carcinoma is seen most commonly in parotid gland and rarely in submandibular gland. We present a case of primary squamous cell carcinoma of right submandibular salivary gland in a 45-year old-man. This case is presented for the rare entity of primary squamous cell carcinoma in submandibular salivary gland.

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