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Sindhwani G.,Guru Gobind Singh Medical College | Shirazi N.,Himalayan Institute of Medical science | Sodhi R.,Himalayan Institute of Medical science | Raghuvanshi S.,Himalayan Institute of Medical science | Rawat J.,Himalayan Institute of Medical science
Lung India | Year: 2015

Background: Diffuse parenchymal lung diseases (DPLD) are a group of disorders characterized by chest radiological findings of bilateral diffuse shadowing. Lung biopsy is generally required to make an etiological diagnosis of DPLD's. Transbronchial lung biopsy (TBLB) is a minimally invasive method to achieve a lung sample which has been found to be a useful diagnostic tool in patients with DPLD. As per American Thoracic Society guidelines for management of idiopathic interstitial pneumonias, TBLB is not required in patients who have findings consistent with idiopathic pulmonary fibrosis (IPF) on HRCT scan thorax. Some Indian researchers have evaluated, on a small number of subjects, the role of TBLB in patients with DPLD, but they had not excluded patients with 'IPF pattern'. This study was planned to assess TBLB in patients with DPLD after excluding patients with 'IPF pattern'. Materials and Methods: A prospective non-randomized study on 49 patients with DPLD without a characteristic 'IPF pattern' were subjected to TBLB. Results: The overall diagnostic yield of TBLB was 85.7%. Non-specific interstitial pneumonitis, tuberculosis and sarcoidosis were the most common histology patterns found (22.4, 18.4 and 16.3%, respectively). Procedure-related mortality was nil. Iatrogenic pneumothorax occurred in five patients (10.2%). Minor complications included hemorrhage and transient hypoxia. Conclusion: TBLB is a safe and effective tool in the diagnosis of DPLD. Source

Ahi R.S.,Adesh Institute of Medical Science and Research | Arora D.,Guru Gobind Singh Medical College | Singh R.S.,Adesh Institute of Medical Science and Research
Journal of Clinical and Diagnostic Research | Year: 2010

Oxidative stress is implicated in the pathogenesis of many diseases. It has been evidenced by various studies that free radicals are involved in the progression of pulmonary tuberculosis and also, in the damage caused to the lung tissue. Aim: The present study was conducted to assess the severity of oxidative stress (MDA) and the levels of antioxidants (vitamin C) in advanced (cavitary) pulmonary tuberculosis by comparing it with the non cavitary cases. Methodology: 50 cases and 30 controls were included in this study. The cases were further divided into cavitary and non-cavitary on the basis of the chest X-ray reports. The levels of lipid peroxidation (MDA) were estimated by the method of Stocks and Dormandy and those of vitamin C were estimated by the method of Varley. Result: The levels of lipid peroxidation increased significantly in the cavitary cases and also, the levels of the antioxidants (vitamin C) were found to be decreased significantly in the cavitary cases as compared to the non-cavitary cases. Conclusion: Oxidative stress was found to be increased highly significantly in cavitary pulmonary tuberculosis. The levels of the antioxidants (vitamin C) decreased highly significantly with an increase in lipid peroxidation levels. Source

Segan R.,Guru Gobind Singh Medical College | Gupta V.,Dayanand Medical College and Hospital | Walia L.,Dayanand Medical College and Hospital | Mittal N.,Dayanand Medical College and Hospital
National Journal of Physiology, Pharmacy and Pharmacology | Year: 2013

Background: Unexplained sudden deaths due cardiac involvement are linked to autonomic neuropathy in diabetics but mechanisms remain unclear. Heart rate and pulse pressure etc have been used to predict cardiovascular risk. But the association of Rate Pressure Product remains unascertained. Objective: To predict cardiovascular risk in type 2 diabetic patients with cardiac autonomic neuropathy using a noninvasive indicator, rate pressure product Materials and Methods: Case control study done on two groups of 20 each, age matched type 2 diabetics with/without cardiac autonomic neuropathy and matched with 20 controls of either sex (n=60). Rate Pressure Product was measured in response to cold pressor and hand grip test. Statistical analysis was done using SPSS software by paired and unpaired t test Results: There was a significant increase in rate pressure product in controls and in patients without autonomic neuropathy after the tests (p<0.001). Patients with autonomic neuropathy had non-significant increase in rate pressure product (p>0.001). The change in RPP (ΔRPP) was least in diabetics with autonomic neuropathy and significant in controls and non-neuropathy diabetics using unpaired t-test (plt; 0.05). Resting RPP was recorded highest in diabetic autonomic neuropathy patients. Conclusion: Heightened resting RPP and failure of Rate Pressure Product increment during cardiac sympathetic stimulation promotes aggravated ischemic episodes. This renders autonomic neuropathy diabetics vulnerable to adverse cardiovascular events leading to increased morbidity and mortality. Source

Devi L.,Guru Gobind Singh Medical College | Tandon R.,Government Medical College Hospital | Goel P.,Government Medical College Hospital | Huria A.,Government Medical College Hospital | Saha P.K.,Government Medical College Hospital
Tropical Doctor | Year: 2012

We sought to identify the characteristic features of pelvic tuberculosis (TB) in women with symptoms and sonogaphic findings which were otherwise consistent with an ovarian malignancy. This study is a retrospective analysis of 138 women who underwent an operation and had a preoperative diagnosis of ovarian malignancy at the Government Medical College Hospital, Chandigarh, from January 2004 to January 2008. Among these 138 women, seven cases (5.7%) of pelvic TB were identified. Abdominal pain and distension were the most common presenting symptoms. All patients had a pelvic mass, six had ascites (85%) and five had a fever (71%). The mean cancer antigen (CA) 125 level was 295 IU (13-529). Pelvic TB can present with symptoms and signs which mimic ovarian malignancy. Therefore, a high-index of clinical suspicion should be maintained when treating patients in countries with a high prevalence of TB. Source

Singh H.,Guru Gobind Singh Medical College | Azad K.,Government Medical College | Kaur K.,Guru Gobind Singh Medical College
Indian Journal of Pharmacology | Year: 2013

Clofazimine-induced crystal-storing histiocytosis is a rare but well-recognized condition reported in literature. In addition to common reddish discoloration of the skin, clofazimine produces gastrointestinal disorder, sometimes severe abdominal pain. Also, the pathologic and radiologic findings can produce diagnostic difficulties if the pathological changes caused by it are not known. The authors report a case in a patient of leprosy to emphasize the importance of history, radiologic, and pathologic findings in small intestine. Clofazimine crystals are red in the frozen section and display bright-red birefringence. With the knowledge of this rare condition caused by clofazimine, appropriate management to avoid an unnecessary laparotomy is possible. Source

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