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Sharma T.,Christian Eminent College | Joshi P.,Choithram Hospital and Research Center
International Journal of Pharma and Bio Sciences | Year: 2013

Neisseria meningitidis is the principal cause of bacterial meningitis. Bacteria can be transmitted by carriers through the droplets of respiratory secretions and can only infect humans. The mortality rate of bacterial meningitis is very high even after the discovery of many antibiotics. Acquisition of iron is the major determinant in the pathogenesis of Neisseria meningitidis which is fulfilled by human host proteins like transferrin, lactoferrin, hemoglobin, and haptoglobin-hemoglobin. Present study is performed on transferrin binding protein A, transferrin binding protein B, lactoferrin binding protein A and lactoferrin binding protein B which together constitutes receptors for human transferrin, and lactoferrin iron complex in Neisseria menningitidis which further are responsible for the transport of essential iron. Crystal structures of TbpA and TbpB are taken from Protein data bank while sequences of LbpA and LbpB are retrieved from NCBI and modeled by using Geno3D. Molecular docking studies are performed by taking Juglone or 5 hydroxy 1-4 naphthoqinone as a ligand. Binding energies are calculated and interactions are studied. Our findings suggest Juglone shows effective binding with these proteins with much lesser binding energies can be used for clinical trials for the treatment of meningitis. Source

Gupta V.,Chhatrapati Shahuji Maharaj Medical University | Gupta P.,Eras Lucknow Medical College | Jain A.,Choithram Hospital and Research Center
Journal of the Pancreas | Year: 2011

Context Brunner's gland adenoma is a rare benign duodenal neoplasm. It usually presents with luminal obstruction or gastrointestinal bleeding. In rare cases, it may mimic a pancreatic malignancy and may present with obstructive jaundice. Case report A 65-year-old female presented with a two-month history of abdominal pain, early satiety and retrosternal burning pain. Liver function tests showed elevated enzymes with normal bilirubin. Imaging studies revealed a large mass in relation to the uncinate process of the pancreas and the distal duodenum along with the dilated common bile duct and the main pancreatic duct. Initial endoscopic evaluation failed to make a correct diagnosis. Repeat endoscopic evaluation combined with endoscopic sonography, however, revealed a large polypoid mass arising from the duodenal bulb. The patient underwent a transduodenal polypectomy. A diagnosis of Brunner's gland adenoma was made on histopathological examination. Conclusion Giant Brunner's adenoma may have unusual presentations. It may present with the features of ampullary obstruction mimicking periampullary or pancreatic malignancies. Extensive preoperative evaluation is required to reach a correct diagnosis in order to avoid more extensive surgery. Source

Saha K.K.,Fortis S. L. Raheja Hospital | Deval M.,Fortis S. L. Raheja Hospital | Jagdale L.,Fortis S. L. Raheja Hospital | Sahani P.,Choithram Hospital and Research Center
Heart Surgery Forum | Year: 2011

Background: The advantages of off-pump coronary artery bypass grafting (OPCAB) are well documented; however, the conversion of OPCAB to cardiopulmonary bypass (CPB) is associated with higher morbidity and mortality. This issue is of particular concern in low-volume centers or centers that are beginning to use OPCAB. We present an OPCAB methodology that uses a maximum number of arterial grafts. Methods: We routinely use OPCAB in every patient unless there is another associated condition. We used the following methods to improve the safety of OPCAB: (1) maintaining normothermia, (2) routine use of a pulmonary artery catheter, (3) routine use of a femoral arterial line, (4) routine use of a cell saver, and (5) complete revascularization. Results: We included 173 consecutive patients in the study. All patients underwent OPCAB without any conversion to CPB. Hemodynamic compromise in 5 patients (2.89%) required insertion of an intra-aortic balloon pump (IABP). OPCAB was completed in all 5 patients after IABP insertion. Blood transfusions (BTs) were avoided in 55 patients (31.8%), and 68 patients (39.3%) required ≤2 units of blood. Conclusion: The OPCAB technique is still evolving. Low-volume centers have higher rates of conversion to CPB. Hypotension due to an impaired left ventricular function can be successfully treated by using an IABP. Although blood loss can be managed with BTs, use of a cell saver helps to reduce the number of BTs. We conclude that our technique of total arterial OPCAB using a cell saver can be safely performed in a low-volume center. © 2011 Forum Multimedia Publishing, LLC. Source

Gokhale S.,Choithram Hospital and Research Center
Ultrasound Clinics | Year: 2010

Color Doppler ultrasonography is an excellent screening modality for renovascular hypertension (RVH). The technique is one of the most challenging ultrasound examinations; nevertheless, with expertise and skill, it is possible to perform a technically acceptable examination in most patients. This article will highlight this technique's use in patients with RVH. © 2010 Elsevier Inc. Source

Jain J.,Choithram Hospital and Research Center | Jain M.,Choithram Hospital and Research Center
Tropical Doctor | Year: 2013

SUMMARY Acute viral hepatitis A and E (HAV/HEV) are usually self-limiting illnesses. However, they can have atypical presentations which lead to increased morbidity andmortality.We studied 81patients fromall age groups admitted with these infections at our centre over a1year period. Acute liver failure, prolonged cholestasis, ascites and haemolysis are common atypicalmanifestations of acute viral HAVand HEV. Relapsing hepatitis, ascites and double peak jaundicewere seenmore often in the paediatric age group. Source

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