Chhatrapati Shahuji Maharaj Medical University
Chinnachowk, India
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Zainul Z.,Chhatrapati Shahuji Maharaj Medical University
EXCLI Journal | Year: 2011

Tobacco smoking is the common practice in a large percentage of the population worldwide, and the incidence is continuously increasing. Tobacco smoking is the most preventable cause of lung cancer, and it also impairs oral health. People are aware of the carcinogenic effects of tobacco smoking on the lungs and oral cavity, but it is also a risk factor for many other harmful diseases. This review article covers most of the diseases that are associated with tobacco smoking, such as coronary artery disease (CAD), diabetes, chronic obstructive pulmonary disease (COPD), arthritis, impotency, infertility, tuberculosis, and Alzheimer's disease. The association of these diseases with tobacco smoking is discussed in detail in this review, along with their possible pathophysiology. This article focuses on the ongoing research of these diseases, and aims to raise awareness of the hazards of tobacco smoking, and to promote antismoking awareness programs.

Kaur A.,Chhatrapati Shahuji Maharaj Medical University
Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH | Year: 2012

To analyze cases undergoing orbital exenteration in terms of demographic and socioeconomic profile of patients, indications for surgery, histopathological diagnosis and to assess the magnitude of eyelid malignancies as indication of orbital exenteration. A case record analysis of 25 patients who underwent orbital ex enteration at a tertiary care centre in India between October 2002 and October 2007 was undertaken. The case records were reviewed to obtain demographic data, presenting symptoms, duration of symptoms, laterality, best-corrected visual acuity (BCVA), and the clinical and histopathological diagnosis. The age group of patients undergoing exenteration ranged from 1 year to 78 years (Mean 46.92 +/- 10 years). Proptosis and/or a palpable mass were the main presenting complaints in 80 % of cases. The duration of symptoms was more than 5 years in 80 % cases. Primary orbital malignancies were the commonest indication for exenteration and were diagnosed in 11 cases (44 %), followed by lid malignancies in 8 cases (32 %), retinoblastoma in 4 cases (16 %) and conjunctival malignancies in 2 cases (8 %). Sebaceous gland carcinoma was the commonest lid malignancy followed by basal cell carcinoma and squamous cell carcinoma. Lid malignancies contribute the majority of the patients undergoing orbital exenteration in this part of the world, leading to an extreme sacrifice of eyes with good visual acuity. Increase in awareness, early diagnosis and prompt referral may help to overcome this grim scenario. © NEPjOPH.

Tikku A.P.,Chhatrapati Shahuji Maharaj Medical University
Journal of oral science | Year: 2010

This study evaluated the effectiveness of ultrasound, color Doppler imaging and conventional radiography in monitoring the post-surgical healing of periapical lesions of endodontic origin. Fifteen patients who underwent periapical surgery for endodontic pathology were randomly selected. In all patients, periapical lesions were evaluated preoperatively using ultrasound, color Doppler imaging and conventional radiography, to analyze characteristics such as size, shape and dimensions. On radiographic evaluation, dimensions were measured in the superoinferior and mesiodistal direction using image-analysis software. Ultrasound evaluation was used to measure the changes in shape and dimensions on the anteroposterior, superoinferior, and mesiodistal planes. Color Doppler imaging was used to detect the blood-flow velocity. Postoperative healing was monitored in all patients at 1 week and 6 months by using ultrasound and color Doppler imaging, together with conventional radiography. The findings were then analyzed to evaluate the effectiveness of the 3 imaging techniques. At 6 months, ultrasound and color Doppler imaging were significantly better than conventional radiography in detecting changes in the healing of hard tissue at the surgical site (P < 0.004). This study demonstrates that ultrasound and color Doppler imaging have the potential to supplement conventional radiography in monitoring the post-surgical healing of periapical lesions of endodontic origin.

Gupta A.,Chhatrapati Shahuji Maharaj Medical University | Gupta V.,Chhatrapati Shahuji Maharaj Medical University
BioScience Trends | Year: 2010

Metabolic syndrome (MetS) is a widely prevalent and multi-factorial disorder. The syndrome has been given several names such as insulin resistance (IR) syndrome, plurimetabolic syndrome, Reaven's syndrome, Syndrome X, and the deadly quartet. The formulation of National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP) guidelines has led to some uniformity and standardization of the definition of MetS and has been helpful epidemiologically. The clinical relevance of MetS is related to its role in the development of cardiovascular disease. Weight reduction is one of the mainstays of treatment. This article provides a comprehensive discussion of metabolic risk factors, the history of MetS, and its diagnosis, epidemiology, etiology, pathophysiology, and treatment. There is a need to comprehensively review this particular syndrome in view of the ever increasing-incidence of this condition.

Garg R.K.,Chhatrapati Shahuji Maharaj Medical University | Malhotra H.S.,Chhatrapati Shahuji Maharaj Medical University
Expert Review of Anti-Infective Therapy | Year: 2012

Solitary cysticercus granuloma is considered the most frequent type of neurocysticercosis in India and many other southeast Asian countries. It has frequently been reported from developed countries in immigrant populations. Genetic susceptibility has recently been linked with Toll-like receptor gene polymorphisms. These lesions are the most frequent neuroimaging abnormality seen in patients with new-onset epilepsy. Solitary cysticercus granuloma is seen on a contrast computed tomography as an enhancing ring-shaped lesion. These enhancing lesions are usually less than 20 mm in diameter and are surrounded by a varying amount of perilesional vasogenic edema. A variety of infectious, neoplastic, inflammatory or vascular diseases can manifest with a single ring-enhancing lesion of the brain, and differential diagnosis may be challenging. The most difficult differential diagnosis is small intracranial tuberculoma. Immunodiagnosis is often not helpful in the patients with single lesions. Antiepileptic treatment is the most important option. Albendazole and corticosteroids are of questionable value. Prognosis is generally good. Antiepileptic therapy can be withdrawn after disappearance of the lesion. Calcification of the lesion and perilesional gliosis may be responsible for frequent seizure recurrences. © 2012 Expert Reviews Ltd.

Dubey P.P.,Chhatrapati Shahuji Maharaj Medical University
Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand | Year: 2011

The purpose of this study was to assess vascularity of the lunate by number of foramina and radiography of vessels of the wrist. The genesis of lunatomalacia requires some vascular risk and mechanical predisposition. The findings were correlated with the cause of Kienböck's disease. The vascular foramina were more than two in 91.33% of the lunate. The lunate had consistent dorsal and palmar branches from radial artery. The additional branches from anterior interosseous artery in 72.22% and a branch of palmar inter carpal arch in 69.44% cases contributed in arterial anastomosis on palmar aspect of lunate. The dorsal blood supply was found by anterior interosseous artery in 85.71% of specimens and dorsal branch from dorsal intercarpal arch in 50% of specimens. The blood supply of lunate comes along with various ligaments which may be disrupted due to trauma or strain leading to avascular necrosis. The present observations are suggestive of rich blood supply of lunate in comparison of other investigations. Therefore Kienböck's disease is less common in northern India.

Garg R.K.,Chhatrapati Shahuji Maharaj Medical University
Acta Neurologica Scandinavica | Year: 2010

Tuberculous meningitis is a severe form of extrapulmonary tuberculosis. The exact incidence and prevalence are not known. In countries with high burden of pulmonary tuberculosis, the incidence is expected to be proportionately high. Children are much more vulnerable. Human immunodeficiency virus-infected patients have a high incidence of tuberculous meningitis. The hallmark pathological processes are meningeal inflammation, basal exudates, vasculitis and hydrocephalus. Headache, vomiting, meningeal signs, focal deficits, vision loss, cranial nerve palsies and raised intracranial pressure are dominant clinical features. Diagnosis is based on the characteristic clinical picture, neuroimaging abnormalities and cerebrospinal fluid changes (increased protein, low glucose and mononuclear cell pleocytosis). Cerebrospinal fluid smear examination, mycobacterial culture or polymerase chain reaction is mandatory for bacteriological confirmation. The mortality and morbidity of tuberculous meningitis are exceptionally high. Prompt diagnosis and early treatment are crucial. Decision to start antituberculous treatment is often empirical. WHO guidelines recommend a 6 months course of antituberculous treatment; however, other guidelines recommend a prolonged treatment extended to 9 or 12 months. Corticosteroids reduce the number of deaths. Resistance to antituberculous drugs is associated with a high mortality. Patients with hydrocephalus may need ventriculo-peritoneal shunting. Bacillus Calmette-Guérin vaccination protects to some degree against tuberculous meningitis in children. © 2009 Blackwell Munksgaard.

Garg R.K.,Chhatrapati Shahuji Maharaj Medical University | Somvanshi D.S.,Chhatrapati Shahuji Maharaj Medical University
Journal of Spinal Cord Medicine | Year: 2011

Spinal tuberculosis is a destructive form of tuberculosis. It accounts for approximately half of all cases of musculoskeletal tuberculosis. Spinal tuberculosis is more common in children and young adults. The incidence of spinal tuberculosis is increasing in developed nations. Genetic susceptibility to spinal tuberculosis has recently been demonstrated. Characteristically, there is destruction of the intervertebral disk space and the adjacent vertebral bodies, collapse of the spinal elements, and anterior wedging leading to kyphosis and gibbus formation. The thoracic region of vertebral column is most frequently affected. Formation of a 'cold' abscess around the lesion is another characteristic feature. The incidence of multi-level noncontiguous vertebral tuberculosis occurs more frequently than previously recognized. Common clinical manifestations include constitutional symptoms, back pain, spinal tenderness, paraplegia, and spinal deformities. For the diagnosis of spinal tuberculosis magnetic resonance imaging is more sensitive imaging technique than x-ray and more specific than computed tomography. Magnetic resonance imaging frequently demonstrates involvement of the vertebral bodies on either side of the disk, disk destruction, cold abscess, vertebral collapse, and presence of vertebral column deformities. Neuroimaging-guided needle biopsy from the affected site in the center of the vertebral body is the gold standard technique for early histopathological diagnosis. Antituberculous treatment remains the cornerstone of treatment. Surgery may be required in selected cases, e.g. large abscess formation, severe kyphosis, an evolving neurological deficit, or lack of response to medical treatment. With early diagnosis and early treatment, prognosis is generally good. © The Academy for Spinal Cord Injury Professionals, Inc. 2011.

Garg R.K.,Chhatrapati Shahuji Maharaj Medical University | Sinha M.K.,Chhatrapati Shahuji Maharaj Medical University
Journal of Neurology | Year: 2011

Tuberculosis is the most common opportunistic infection in human immunodeficiency virus (HIV) infected persons. HIV-infected patients have a high incidence of tuberculous meningitis as well. The exact incidence and prevalence of tuberculous meningitis in HIV-infected patients are not known. HIV infection does not significantly alter the clinical manifestations, laboratory, radiographic findings, or the response to therapy. Still, some differences have been noted. For example, the histopathological examination of exudates in HIV-infected patients shows fewer lymphocytes, epithelioid cells, and Langhan's type of giant cells. Larger numbers of acid-fast bacilli may be seen in the cerebral parenchyma and meninges. The chest radiograph is abnormal in up to 46% of patients with tuberculous meningitis. Tuberculous meningitis is likely to present with cerebral infarcts and mass lesions. Cryptococcal meningitis is important in differential diagnosis. The recommended duration of treatment in HIV-infected patients is 9-12 months. The benefit of adjunctive corticosteroids is uncertain. Antiretroviral therapy and antituberculosis treatment should be initiated at the same time, regardless of CD4 cell counts. Tuberculous meningitis may be a manifestation of paradoxical tuberculosis-associated immune reconstitution inflammatory syndrome. Some studies have demonstrated a significant impact of HIV co-infection on mortality from tuberculous meningitis. HIV-infected patients with multidrug-resistant tuberculous meningitis have significantly higher mortality. The best way to prevent HIV-associated tuberculous meningitis is to diagnose and isolate infectious cases of tuberculosis promptly and administer appropriate treatment. © 2010 Springer-Verlag.

Vijay S.K.,Chhatrapati Shahuji Maharaj Medical University
Echocardiography | Year: 2012

(Echocardiography 2012;29:E48-E49) Mitral annular abscess is an uncommon entity that rarely develops during the course of infective endocarditis. In this report, we present a case of a young girl who presented with acute decompensated heart failure due to acute mitral regurgitation caused by an abscess of the medial mitral annulus that perforated leading to left ventriculo-atrial fistula. This report includes echocardiographic images of this rare complication of infective endocarditis. © 2011, Wiley Periodicals, Inc.

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