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Udani V.,Hinduja National Hospital and Medical Research Center
Neurology Asia | Year: 2011

Epilepsy due to perinatal brain injury remains an important problem in developing countries. Brain injury can be prominent in perinatal asphyxia, neonatal hypoglycemia, sepsis- meningitis, late hemorrhagic disease of the newborn and perinatal ischemic arterial stroke. The types of epilepsy and a focus on possible prevention in each condition is discussed.

Hari Kumar K.V.S.,Command Hospital | Shaikh A.,Hinduja National Hospital and Medical Research Center | Anwar I.,Command Hospital | Prusty P.,Command Hospital
Pituitary | Year: 2012

Pseudoacromegaly is a condition characterized by cutaneous manifestations of growth hormone excess but with normal growth hormone levels. This is described in patients with severe insulin resistance, pachydermoperiostitis, burnt out acromegaly and with intake of drugs like Minoxidil. Severe thyroid hormone deficiency rarely present with similar picture and the issue is further complicated in presence of pituitary hyperplasia. We report an unusual presentation of primary hypothyroidism with pseudoacromegaly and thyrotroph hyperplasia mimicking a pituitary macroadenoma. The thyrotroph hyperplasia resolved completely with levothyroxine therapy. © 2011 Springer Science+Business Media, LLC.

Joshi V.R.,Hinduja National Hospital and Medical Research Center
Journal of Association of Physicians of India | Year: 2014

Undiagnosed fever is a vexing problem. The reasons why fever remains undiagnosed can be inherent to the underlying pathology, our shortcoming(s) or both. This article describes "our" causes based on cases seen over the years. It is apparent that with proper attention to details mystery of at least some undiagnosed fevers can be solved. © JAPI.

Agarwal M.,Hinduja National Hospital and Medical Research Center | Gulia A.,Tata Memorial Center | Ravi B.,Indian Institute of Technology Bombay | Ghyar R.,Indian Institute of Technology Bombay | Puri A.,Tata Memorial Center
Clinical Orthopaedics and Related Research | Year: 2010

Background: Low-cost indigenous megaprostheses used in the developing world are prone to mechanical failure but the frequency and causes are not well established. Questions/purposes: We retrospectively analyzed the causes of failure, particularly design, and suggest changes to reduce the breakage. We also report our experience with revision surgery. Methods: We identified 28 breakages in 266 megaprosthetic knee arthroplasties performed between January2000 and December 2006. Twenty-six breakages were revised to another prosthesis. The complications were studied and the function was evaluated. Prostheses were studied for failure by the computer-aided design program SolidWorks® and Hyperworks® for finite element analysis (FEA). Design improvements were performed based on these results. Results: In 21 cases, the failure occurred at the stem-collar junction, the point of maximum stress predicted by FEA. Stainless steel implants were prone to failure. There was one early and one late infection. Three patients died of metastatic disease. The most difficult surgical step involved the removal of the well-cemented broken stem from the intramedullary canal. Musculoskeletal Tumor Society scores varied from 27 to 29 after revision. FEA revealed stress could be reduced by filleting the stem-collar junction and by two-piece stems. Conclusions: Revisions of broken total knee megaprostheses, though technically difficult, have allowed patients reasonable function. We recommend design analysis for custom prostheses to point to areas of weakness. Breakages can be reduced by using titanium stems and filleting the junction or by having two-piece inserted stems. Incorporating these changes has reduced the failures in our experience. © 2010 The Association of Bone and Joint Surgeons®.

Sharma V.,Hinduja National Hospital and Medical Research Center
The Journal of the Association of Physicians of India | Year: 2012

We have recently treated three patients with malaria who developed post malaria immune mediated hemolysis. These cases, seen with in a span of three month period (September 09 to November 09) form the basis of this report. Out of three patients, two were treated with steroids and both responded favorably.

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