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Handa R.,Indraprastha Apollo Hospitals
Indian Journal of Rheumatology | Year: 2015

Polyarteritis nodosa (PAN) and microscopic polyangiitis (MPA) are systemic necrotising vasculitides, with a propensity to involve multiple organs. MPA is an ANCA (antineutrophil cytoplasmic antibody)-associated vasculitis while PAN is characterised by the absence of ANCA/other autoantibodies. The clinical profile in India is no different from that reported elsewhere. Lack of physician awareness contributes to diagnostic delays. In absence of disease registries, long-term outcome data from India are sparse. © 2015 Indian Rheumatology Association. Source


Handa R.,Indraprastha Apollo Hospitals
Indian Journal of Rheumatology | Year: 2014

Rheumatology is a neglected subject in postgraduate medical curriculum in India. This article provides the author's perspective on possible reasons and potential solutions. Copyright © 2014, Indian Rheumatology Association. All rights reserved. Source


Agrawal S.,Indraprastha Apollo Hospitals | Daruwala C.,Temple University
Clinical Imaging | Year: 2013

Richter's hernia is associated with rapid onset of gangrene and a high mortality. We report a case of a strangulated inguinal Richter's hernia of the cecum requiring a laparotomy and bowel resection. Due to the misleading clinical presentation, a high index of suspicion, particularly in patients with a history of laparoscopic surgery, will minimize delay in diagnosis. © 2013 Elsevier Inc. Source


Vaishya R.,Indraprastha Apollo Hospitals
Chinese Journal of Traumatology - English Edition | Year: 2012

Avascular necrosis of the femoral head is a known complication of femoral neck fracture but on the contrary, femoral neck fracture in a case of preexisting avascular necrosis is a very rare phenomenon. We present a case study of a 47 year old Iraqi male who developed spontaneous ipsilateral subcapital femoral neck fracture under the condition of preexisting sickle cell disease and avascular necrosis of the femoral head. The fracture was unnoticed for a few months. The patient was managed successfully by uncemented total hip arthroplasty. Postoperative recovery was uneventful and he was discharged 4 days after surgery. At 1 year's follow-up, the patient had normal gait and hip function, with no sign of loosening or any other complications on radiograph. Source


Handa R.,Indraprastha Apollo Hospitals
Nature Reviews Rheumatology | Year: 2015

Rheumatology has been a neglected subspecialty in India. A staggering patient load, a severely inadequate number of trained rheumatology specialists, therapeutic nihilism and limited advocacy are some of the critical challenges that confront rheumatology care, and possibly explain the high rates of reliance on complementary and alternative medicines in India. Disease spectrum and treatment patterns are not remarkably different from those in other countries, but biologic agents have limited use and are administered for short periods only. Consequently, outcomes in India do not yet match those reported in developed countries. Furthermore, the high prevalence of infectious diseases continues to be a major contributor to mortality in patients with rheumatic disorders such as systemic lupus erythematosus. Several tropical diseases with rheumatic manifestations are relevant in India, including chikungunya, brucellosis, leptospirosis, dengue and melioidosis. To address the many problems with rheumatology care in India, curricular reforms, capacity building, patient education and political support are sorely needed. © 2015 Macmillan Publishers Limited. Source

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