Ali S.R.,Bombay Hospital |
Mehta A.C.,Cleveland Clinic
Chest | Year: 2017
Aspiration of a foreign body into the lower airways is a common occurrence and can cause significant morbidity and mortality in humans. Most foreign bodies of the tracheobronchial tree are inanimate. However, the medical literature includes reports of live foreign bodies in the airways. Fish, leeches, and roundworms are the most common live foreign bodies of the lower airways. Fishermen are more prone to experience a live fish aspiration, whereas substandard conditions may expose individuals to leech and roundworm infestations. The dangers of and the approaches to the management of these foreign bodies differ from those associated with aspirated inanimate objects. The focus of this review of the medical literature was on live foreign body aspiration and its management. © 2016 American College of Chest Physicians
Thatte M.R.,Bombay Hospital |
Mehta R.,Jaslok Hospital
Indian Journal of Plastic Surgery | Year: 2011
Obstetric brachial plexus injury (OBPI), also known as birth brachial plexus injury (BBPI), is unfortunately a rather common injury in newborn children. Incidence varies between 0.15 and 3 per 1000 live births in various series and countries. Although spontaneous recovery is known, there is a large subset which does not recover and needs primary or secondary surgical intervention. An extensive review of peer-reviewed publications has been done in this study, including clinical papers, review articles and systematic review of the subject. In addition, the authors' experience of several hundred cases over the last 15 years has been added and has influenced the ultimate text. Causes of OBPI, indications of primary nerve surgery and secondary reconstruction of shoulder, etc. are discussed in detail. Although all affected children do not require surgery in infancy, a substantial proportion of them, however, require it and are better off for it. Secondary surgery is needed for shoulder elbow and hand problems. Results of nerve surgery are very encouraging. Children with OBPI should be seen early by a hand surgeon dealing with brachial plexus injuries. Good results are possible with early and appropriate intervention even in severe cases.
Mansukhani K.A.,Bombay Hospital Institute of Medical science |
Mansukhani K.A.,Bombay Hospital
Annals of Indian Academy of Neurology | Year: 2013
Electrodiagnosis (EDX) is a useful test to accurately localize the site, determine the extent, identify the predominant pathophysiology, and objectively quantify the severity of brachial plexopathies. It can also be used to examine muscles not easily assessed clinically and recognize minimal defects. Post-operatively and on follow up studies, it is important for early detection of re-innervation. It can be used intra-operatively to assess conduction across a neuroma, which would help the surgeon to decide further course of action. Localization of the site of the lesion can be very challenging as there may be multiple sites of involvement and hence the electroneuromyographic evaluation must be adequate. The unaffected limb also needs to be examined for comparison. The final impression must be co-related with the type and severity of injury. © 2013 Annals of Indian Academy of Neurology.
Kumar S.,BYL Nair Ch Hospital and TN Medical College |
Amarapurkar A.,BYL Nair Ch Hospital and TN Medical College |
Amarapurkar D.,Bombay Hospital
Indian Journal of Medical Research | Year: 2013
Background & objectives: Serum alanine aminotransferase (ALT) level is most commonly used as a marker for the assessment of various liver diseases. Currently upper limits of normal for aspartate aminotransferase (AST) or ALT levels used are based on the western literature. This study was conducted to determine the ALT and AST levels in healthy blood donors from western India and to determine the relation with body mass index (BMI) and waist-to-hip ratio (WHR). Methods: A total of 5077 voluntary blood donors were selected with strict routine inclusion and exclusion criteria. Weight, height, BMI and WHR were determined along with AST and ALT levels. BMI and WHR were correlated with liver enzymes. Results: Of the 5077 donors, 160 were excluded due to positive serological results. In the remaining 4917 individuals, 4643 (94.4%) were males and 274 (5.6%) were females. Majority 3024 (61.5%) showed BMI more than 23 kg/m2. WHR > 0.85 and 0.80 was found in 4046 (87.0%) males and 250 (91.2%) females. Mean AST and ALT levels in males were 23.4 ± 9.9 IU/l and 27.0 ± 17.3 IU/l and in females 19.1 ± 9.8 IU/l and 17.7 ± 11.2 IU/l, respectively. With increase in BMI, there was a significant increase in AST and ALT levels. Similar increase was also seen with WHR. Interpretation & conclusions: Majority of voluntary blood donors showed high BMI and WHR which was directly related to AST and ALT levels. This study highlights the magnitude of obesity in general healthy population of western India and a need to revise the current normal limits of serum ALT.
Kodkani P.S.,Bombay Hospital
Arthroscopy Techniques | Year: 2015
The anatomy of the medial patellofemoral ligament (MPFL) has been well defined, with parts of its uppermost fibers having a soft-tissue insertion onto the vastus intermedius. Bone tunnels and implants on the patellar side therefore cannot replicate this anatomic construct precisely. Because of implants and tunnels, complications have been reported with bone tunnel fracture. Similarly, on the femoral side, rigid fixation with implants can result in over-constraint with compromised results. Moreover, bone tunnels cannot be used in skeletally immature cases. To overcome issues related to bone tunneling and implants, as well as to reconstruct the MPFL in a precise anatomic manner, an all-soft-tissue fixation technique was devised. Bony landmarks were used as reference points instead of radiologic markers to achieve a moreprecise construct and to eliminate intraoperative radiography. Hamstring graft was used to reconstruct the MPFL. Special suturing techniques were used to achieve optimal graft fixation with minimal suture knots. A special tissue elevator-suture passer device was designed to facilitate graft passage and ease in performing the procedure. This technique permits differential tensioning, and therefore one achieves stability throughout the range of motion. © 2015 Arthroscopy Association of North America.
Nerurkar N.,Bombay Hospital |
Chhapola S.,Bombay Hospital
American Journal of Otolaryngology - Head and Neck Medicine and Surgery | Year: 2012
Korman et al (Laryngoscope.1973;83:683-690) first reported arytenoid dislocation as a rare and unusual complication of intubation. Since then, the terms arytenoid dislocation and arytenoid subluxation (AS) have been used interchangeably to describe disruption of the cricoarytenoid joint. Only 74 cases of AS have been reported in the literature to date. The most common cause of AS is intubation trauma and external neck injury. Only 1 case of AS due to coughing has been documented. Arytenoid subluxation cases are often misdiagnosed as vocal fold paralysis. A high index of suspicion based on the history, examination findings, and objective tests helps in early diagnosis and, thus, early surgical intervention. We present a rare etiology of AS due to a bout of coughing, which was diagnosed early and reduced under general anesthesia with complete reversibility of vocal fold motion, thus restoring normal voice function. © 2012 Elsevier Inc. All rights reserved.
Nerurkar N.K.,Bombay Hospital |
Banu T.P.,Bombay Hospital
Journal of Laryngology and Otology | Year: 2014
Objectives: This study aimed to evaluate the demographics of spasmodic dysphonia in the Indian population and to analyse the optimum dose titration of botulinum toxin type A in this group. A comparative analysis with international studies was also performed. Method: The study involved a retrospective analysis and audit of botulinum toxin type A dose titration in spasmodic dysphonia patients who visited our voice clinic between January 2005 and January 2012. Results: The average total therapeutic dose required for patients with adductor spasmodic dysphonia was 4.2 U per patient per vocal fold (total 8.4 U per patient), and for patients with abductor spasmodic dysphonia, it was 4.6 U per patient. Conclusion: Our audit revealed that 80 per cent of the spasmodic dysphonia patients were male, which contrasts dramatically with international studies, wherein around 80 per cent of spasmodic dysphonia patients were female. Our study also revealed a higher dose titration of botulinum toxin for the Indian spasmodic dysphonia population in both adductor and abductor spasmodic dysphonia cases. Copyright © JLO (1984) Limited 2014.
Shah D.,Breach Candy Hospital |
Agrawal S.,Bombay Hospital
Seminars in Reproductive Medicine | Year: 2010
Vasomotor symptoms (VMS) are recognized to adversely affect the quality of life. The prevalence and the magnitude of VMS may vary across populations. Although a natural regression of VMS may be expected over a period of time, it remains the most common of symptoms for which women seek help. Menopausal hormone therapy (MHT) is currently the only treatment approved by the Food and Drug Administration that has shown uniform benefit in the management of VMS. In clinical situations when estrogen is or may be contraindicated, a finite number of alternative options, including use of neuroactive agents (SSRIs, SSNRs, and gabapentin), lifestyle changes, and nonprescription remedies such as phytoestrogens and black cohosh have been shown to provide relief, albeit with mixed results and questionable safety. Existing data identify an ethnic variation in the degree and frequency of VMS of aging; in this latter context, the Asian woman's perspective is dominantly conveyed from the perspective of Chinese and Japanese ethnicities, whereas data regarding the magnitude of burden of VMS in the postmenopausal women from other Asian ethnicities and races are sparse. This article reviews the symptoms and relates that VMS are of significant concern for the aging Asian women. © 2010 by Thieme Medical Publishers, Inc.
Shah S.P.,Bombay Hospital
Spine | Year: 2012
A case report. To describe an effective surgical option for sacral tuberculosis (TB). Sacral TB is a rare cause of low back pain. A differential diagnosis of TB should always be made, especially in India where TB cases are on a rampant rise with increasing drug resistance and immunosuppressed population. A retrospective review. RESULTS.: We report on a 24-year-old woman with low back pain and radiculopathy. Magnetic Resonance Imaging (MRI) showed a destructive lesion in S1 body. Empirical antitubercular treatment was started elsewhere with no relief but worsening of the lesion. She underwent a Computed Tomography (CT)-guided biopsy and drug sensitivity test, which did not reveal anything. The patient was bedridden for almost a year. A lumbopelvic instrumented fixation and S1 body reconstruction with structural allograft was performed. Culture sensitivity revealed multidrug resistance. After surgery, the patient responded rapidly, and at 2-year follow-up, she is symptom-free. TB should always be considered as a differential diagnosis of sacral lesions, and identifying multidrug resistance is equally important in its treatment. Lumbopelvic fixation is a safe and reliable option as it unloads the S1 segment by achieving fixation in the lumbosacral spine and iliac wings.
News Article | December 27, 2016
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