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Duggal S.,Dr Baba Saheb Ambedkar Hospital | Kaur N.,Dr Rml Pgimer And Hospital | Hans C.,Dr Rml Pgimer And Hospital
Journal of Clinical and Diagnostic Research | Year: 2011

Introduction: MRSA (Methicillin Resistant Staphylococcus aureus) deserves special attention in health care settings. It becomes difficult to treat this infection/eradicate its colonization once it has established. However, its spread can be controlled. An increase in MRSA isolation from the wound swabs of the burns patients over a period of four months prompted us to undertake the present investigation. Material and Methods: Eleven HCWs (Health Care workers) were screened. Hand smears and nasal swabs were cultured and identified by standard microbiological methods. A re-orientation programme was arranged for all HCWs in the burns ward and the importance of standard work precautions, especially hand hygiene was highlighted. Swabs were taken from the same workers after six weeks. Results: Out of eleven health care workers, seven were found to be MRSA carriers (63.6%). Swabs which were taken from the same workers after six weeks, revealed a decrease in the MRSA colonization in the hands by 75% and in the nose by 25%. Also, the number of MRSA isolations from the wound swabs of patients in the burns ward decreased from 35.3% to 13.9%. Conclusion: The current study emphasizes the need for an early diagnosis of MRSA and for being vigilant so that if any outbreak of multidrug resistant organisms occurs in a ward/ ICU, steps to control them can be initiated at the earliest. Italso highlights the importance of hand hygiene so that the hands that deliver care may not deliver germs.


Duggal S.,Dr Baba Saheb Ambedkar Hospital | Chugh T.D.,BLK Superspeciality Hospital | Duggal A.K.,Dr Ram Manohar Lohia Hospital
Clinical and Developmental Immunology | Year: 2012

HIV or human immunodeficiency virus infection has assumed worldwide proportions and importance in just a span of 25 years. Continuous research is being done in many parts of the world regarding its treatment and vaccine development, and a lot of money has flown into this. However, fully understanding the mechanisms of immune depletion has still not been possible. The focus has also been on improving the quality of life of people living with HIV/AIDS through education, counselling, and nutritional support. Malnutrition further reduces the capacity of the body to fight this infection by compromising various immune parameters. Knowledge of essential components of nutrition and incorporating them in the management goes a long way in improving quality of life and better survival in HIV-infected patients. Copyright © 2012 Shalini Duggal et al.


Duggal S.,Dr Baba Saheb Ambedkar Hospital | Chugh T.D.,BLK Superspeciality Hospital
Journal of Pediatric Infectious Diseases | Year: 2014

Pasteurella multocida has rarely been reported as a cause of brain abscess. A 14 year old child was brought to the pediatric emergency department with fever, headache and weakness in left side of the body. Investigations revealed subdural and maxillary sinus abscesses from which Pasteurella multocida and Streptococcus sanguis were concurrently isolated. The case was successfully managed by parenteral ceftriaxone. History revealed frequent exposures with a pet dog. The present case underscores the importance of educating the pet owners, especially children about cross-over of bacteria resulting in serious infections. © 2014 - IOS Press and the authors. All rights reserved.


PubMed | Ganesh Shankar Vidyarthi Memorial Medical College and Dr Baba Saheb Ambedkar Hospital
Type: Journal Article | Journal: Journal of cytology | Year: 2016

Intraoperative cytology and frozen section play an important role in the diagnosis of neurosurgical specimens. There are limitations in both these procedures but understanding the errors and pitfalls may help in increasing the diagnostic yield.To find the diagnostic accuracy of intraoperative cytology and frozen section for central and peripheral nervous system (PNS) lesions and analyze the errors, pitfalls, and limitations in these procedures.Eighty cases were included in this prospective study in a span of 1.5 years.The crush preparations and the frozen sections were stained with hematoxylin and eosin method. The diagnosis of crush smears and the frozen sections were compared with the diagnosis in the paraffin section, which was considered as the gold standard.Diagnostic accuracy, sensitivity, and specificity.The diagnostic accuracy of crush smears was 91.25% with a sensitivity of 95.5% and specificity of 100%. In the frozen sections, the overall diagnostic accuracy was 95%, sensitivity was 96.8%, and specificity was 100%. The categories of pitfalls noted in this study were categorization of spindle cell lesions, differentiation of oligodendroglioma from astrocytoma in frozen sections, differentiation of coagulative tumor necrosis of glioblastoma multiforme (GBM) from the caseous necrosis of tuberculosis, grading of gliomas in frozen section, and differentiation of the normal granular cells of the cerebellum from the lymphocytes in cytological smears.Crush smear and frozen section are complimentary procedures. When both are used together, the diagnostic yield is substantially increased.


Kala P.,Dr Baba Saheb Ambedkar Hospital | Khare P.,Dr Baba Saheb Ambedkar Hospital
Journal of Cytology | Year: 2014

Background: Cysticercosis, a parasitic tissue infection caused by the larva of Taenia solium, is quite a common disease in our part of the world, but its incidence is often underestimated. Fine-needle aspiration cytology (FNAC) plays an important role in early detection of this disease, especially when the lesion is located in anatomically approachable superficial locations. Aims: The aim was to study role of FNAC in the diagnosis of cysticercosis. Materials and Methods: In this retrospective study, the data of 137 patients with palpable nodules, who were diagnosed as having or suspicious of cysticercosis on FNAC, were retrieved and analyzed. Results: In 129 (94.2%) cases, a definitive diagnosis of cysticercosis was obtained in the form of parts of parasite tegument, hooklets, parenchymatous portion and calcareous corpuscles. In the background, giant cells, mixed inflammatory cells, and epithelioid cells were present. In remaining 8 (5.8%) cases, larval fragments could not be identified on the aspirates, and the diagnosis of parasitic inflammation was suggested on the basis of other cytological findings such as clear fluid aspirate, presence of eosinophils, histiocytes, foreign body giant cells, a typical granular dirty background, etc. Follow-up biopsy in these 8 cases confirmed the diagnosis of cysticercosis in 7 (87.5%) while in 1 (12.5%) case, histopathology was suggestive of parasitic cyst. Conclusion: Fine-needle aspiration cytology in cysticercosis is a low-cost outpatient procedure. The cytological diagnosis is quite straightforward in cases where the actual parasite structures are identified in the smears. In other cases, a cytological diagnosis of suspicious of cysticercosis can be given if the cytological findings suggest the same.


Malik I.,Dr Baba Saheb Ambedkar Hospital | Wadhwa R.,Dr Baba Saheb Ambedkar Hospital
Anesthesiology Research and Practice | Year: 2016

Percutaneous nephrolithotomy (PCNL), a minimally invasive method for removal of renal calculi, was initially started in the 1950s but gained popularity about two decades later and has now become standard practice for management. There has been an immense improvement in technique and various guidelines have been established for treatment of renal stones. However, it has its own share of complications which can be attributed to surgical technique as well as anesthesia related complications. PubMed and Google search yielded more than 30 articles describing the different complications seen in this procedure, out of which 15 major articles were selected for writing this review. The aim of this review article is to describe the implications of the complications associated with PCNL related to the anesthesiologist. The anesthesiologist is as much responsible for the management of the patient perioperatively as the surgeon. Therefore, it is mandatory to be familiar with the various complications, some of which may be life threatening and he should be able to manage them efficiently. The paper also analyses the advantages and drawbacks of the available options in anesthesia, that is, general and regional, both of which are employed for PCNL. © 2016 Indira Malik and Rachna Wadhwa.


PubMed | Dr Baba Saheb Ambedkar Hospital
Type: | Journal: Anesthesiology research and practice | Year: 2016

Percutaneous nephrolithotomy (PCNL), a minimally invasive method for removal of renal calculi, was initially started in the 1950s but gained popularity about two decades later and has now become standard practice for management. There has been an immense improvement in technique and various guidelines have been established for treatment of renal stones. However, it has its own share of complications which can be attributed to surgical technique as well as anesthesia related complications. PubMed and Google search yielded more than 30 articles describing the different complications seen in this procedure, out of which 15 major articles were selected for writing this review. The aim of this review article is to describe the implications of the complications associated with PCNL related to the anesthesiologist. The anesthesiologist is as much responsible for the management of the patient perioperatively as the surgeon. Therefore, it is mandatory to be familiar with the various complications, some of which may be life threatening and he should be able to manage them efficiently. The paper also analyses the advantages and drawbacks of the available options in anesthesia, that is, general and regional, both of which are employed for PCNL.


PubMed | Dr Baba Saheb Ambedkar Hospital
Type: Journal Article | Journal: Indian journal of medical microbiology | Year: 2015

The chances of health care waste (Biomedical waste) coming in contact with the health care workers, patients, visitors, sanitary workers, waste handlers, public, rag pickers and animals during transportation are high.The study was conducted over a period of seven months (April 2013-October 2013) in a 500-bedded hospital where the average quantum of biomedical waste is 0.8 kg/bed/day. The issues related to transportation of health care waste from 39 generation sites to the health care waste storage site inside the hospital (intramural transfer) were addressed and analysed in a predesigned proforma.The biomedical waste management team inspected the generation sites in the hospital on a daily basis and conformance to the procedures was checked. It was found that waste was collected at scheduled timings in 99.6% occasions; however, compliance to wearing personal protective equipment (PPE) was poor and ranged from 1.22-1.84%.Transportation of health care waste is a crucial step in its management. Regular training program for all the sections of health care workers with special emphasis on waste handlers is needed.


PubMed | Dr Baba Saheb Ambedkar Hospital
Type: Journal Article | Journal: Postgraduate medicine | Year: 2014

Bacteremia due to Staphylococcus aureus is one of the major causes of morbidity and mortality in India, but studies targeting the source of Staphylococcus aureus bacteremia are lacking. S. aureus has a vivid armamentarium consisting of toxins, adhesins, and other virulence factors by virtue of which it can cause varied types of infections, sometimes of a serious nature. This review highlights the possible causes of S. aureus bacteremia, and discusses the necessity of tracing its source and eliminating it with proper antibiotic therapy to avoid recurrences or relapses.


PubMed | Dr Baba Saheb Ambedkar Hospital
Type: Journal Article | Journal: Journal of cytology | Year: 2016

Tuberculosis is a common disease in developing countries such as India, posing a major public health problem. With human immunodeficiency virus (HIV) infection being a global endemic, there has been a resurgence of tuberculosis even in developed countries. Tuberculosis may affect almost any part of the body. However, tuberculosis of the calvarium is very rare. Presentation of tuberculosis as a soft tissue swelling on the scalp poses a diagnostic problem. These two cases are being reported here to convey the utility of fine-needle aspiration cytology (FNAC) in providing the confirmatory diagnosis obviating the need for invasive surgical procedure.

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