Delhi, India
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Boruah D.K.,Assam Medical College and Hospital | Sanyal S.,Drrml Hospital | Sharma B.K.,Sikkim Manipal Institute of Medical science | Boruah D.R.,Assam Medical College and Hospital
Journal of Clinical and Diagnostic Research | Year: 2016

Introduction: Gall Bladder (GB) perforation, a rare but dreaded complication of acute cholecystitis and is associated with high mortality rate. Early detection of acute cases of GB perforation reduces the risk of biliary peritonitis and hence the associated mortality and morbidity. Aim: The purpose of the study is to make a comparative evaluation of the role of Cross-sectional imaging in GB perforation with base line investigation like sonography. Finally both modalities were compared in determining the type of perforation according to Niemeier’s classification. Materials and Methods: We retrospectively evaluated the Ultrasonography (USG), Computed Tomography (CT) and Magnetic Resonance Imagings (MRI) findings in patients of GB perforation with surgical correlation. Results: We evaluated 17 patients of GB perforations over a time period of one year. USG was done in all patients. As crosssectional modality only CT scan was done in 14 patients and MRI scan was done in four patients. Both CT and MRI scans were done in one patient. Conclusion: Cross-sectional imaging must not be delayed in suspected cases of GB perforations because it helps in establishing a quicker diagnosis, detecting complications and also helps in decision making related to management thereby reducing the morbidity and mortality associated with this condition. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved.

Shankar K.B.,Drrml Hospital | Sharma J.B.,All India Institute of Medical Sciences
Journal International Medical Sciences Academy | Year: 2010

It complicates 1 in 200 pregnancies and is an important cause of seizures. It is defined as a paroxysmal disorder of the central nervous system with an abnormal neuronal discharge with or without loss of consciousness. 17-33% of Seizure frequency increases during pregnancies. Generalized tonic-clonic seizures during pregnancy can lead to increased maternal trauma. If the maternal trauma involves the abdomen, a theoretical risk of abruption exists, possibly leading to fetal hypoxia or death. Furthermore, the risk of maternal aspiration can lead to maternal hypoxia, which can also lead to fetal hypoxia. Women with epilepsy appear to have a greater baseline risk of fetal malformations, which is further increased with the use of antiepileptic drugs (AEDs). First-trimester use of even a single AED is associated with a 2- to 5-fold increase in major malformations. Furthermore, there is an increase in fetal malformations with AED polytherapy. Preconceptual management of women with epilepsy is to decrease pharmacotherapy to monotherapy ,preconceptual genetic counseling. Supplement the diet with folate at 4 mg/d.

Kharbanda P.,Drrml Hospital | Duggal N.,Drrml Hospital | Mahajan R.K.,Drrml Hospital | Chaskar P.,Drrml Hospital | Hans C.,Drrml Hospital
Journal of Pure and Applied Microbiology | Year: 2013

Present study was undertaken to study changing trend of antimicrobial sensitivity of enteric fever causing Salmonella. A total of 2431 strains of Salmonella Typhi and Salmonella Paratyphi A isolated from blood during the period 2008-2010 were included in the study. Ninety percent of Typhi and ninety six percent Paratyphi A isolates were sensitive to Chloramphenicol while sensitivity to ceftriaxone and fluoroquinolones was 89% and 87% respectively. With this emerging trend of increasing sensitivity of enteric fever causing Salmonella to Chloramphenicol, it requires scientific consensus as to whether Chloramphenicol can be kept as reserve drug for cases of quinolone and third generation cephalosporin treatment failure and complicated cases of enteric fever.

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