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PubMed | LRS Institute of Tuberculosis and Respiratory Diseases and Jawahar Lal Nehru Medical College
Type: Journal Article | Journal: Lung India : official organ of Indian Chest Society | Year: 2016

Tuberculosis (TB) is one of the leading causes of death and disease worldwide. Tobacco smoking has been linked as a risk factor for TB. This study was aimed to affirm the strength of association between smoking and pulmonary TB.Pulmonary TB patients aged between 18 and 65 years were enrolled and followed-up until treatment completion. Two consecutive sputum smears were examined from each patient for the presence of acid-fast bacilli (AFB) using Ziehl-Neelsen technique. Radiological severity of disease was assessed using guidelines of National TB Association of USA. Sputum smears for AFB were graded for positivity as per WHO Revised National TB Control Programme criteria. Response was determined in terms of sputum conversion at the end of intensive phase and final treatment outcomes.Sputum smear grading of 3+ increased from 12.5% to 68.18% and 66.66% as smoking index increased from <100 to 100-299 and >300 (P < 0.05). In nonsmokers, 79.2% patients had minimal disease while only 4.2% had advanced disease as compared to smokers where 52.4% had moderate disease, 26.2% advanced disease, and 21.4% minimal disease (P < 0.01). Smokers had significantly lower treatment success rate (69%) as against nonsmokers and former smokers (93.8% and 90.9%, respectively, P = 0.001) owing to a higher default rate among smokers (28.5%) than nonsmokers (6.3%) and former smokers (9.1%).Smokers during initial presentation, as well as at end of the treatment demonstrate more radiological findings, cavitary disease, and worse sputum AFB smear grading. Smokers also have a poorer treatment success rate largely due to high percentage of default rate thus suggesting noncompliance as a main confounder to treatment success. Focus needs to be made to reduce defaulters which are more common among smokers.


Maheshwari M.,Jawahar Lal Nehru Medical College | Tanwar C.P.,Jawahar Lal Nehru Medical College | Mittal S.R.,Jawahar Lal Nehru Medical College
The Journal of the Association of Physicians of India | Year: 2013

We describe herein a 54 year female who had tetralogy of Fallot with quadricuspid aortic valve. This combination is very uncommon. Hence it was worth reporting this interesting case.


Maheshwari M.,Jawahar Lal Nehru Medical College | Kaushik S.K.,Jawahar Lal Nehru Medical College
Journal, Indian Academy of Clinical Medicine | Year: 2014

An interesting case report of paroxysmal atrial fibrillation triggered by Chiari's network is reported herein.


Kumar S.,Jawahar Lal Nehru Medical College | Diwan S.K.,Jawahar Lal Nehru Medical College | Dekate M.,Jawahar Lal Nehru Medical College
Online Journal of Health and Allied Sciences | Year: 2013

Chronic Pancreatitis presenting as recurrent pleural effusion is an uncommon and often unrecognized clinical syndrome. The effusion frequently occurs without clinical evidence of pancreatitis, but occasionally it may be associated with calcification and pseudocyst of the pancreas. They usually presents as an exudative effusion of unknown cause and characterized by very high levels of amylase in the pleural fluid. In this report, a case of massive pancreatic pleural effusions are presented which was recurrent initially right sided and few month later left side.


Kumar S.,Jawahar Lal Nehru Medical College | Jain S.,Jawahar Lal Nehru Medical College | Kashikar S.,Jawahar Lal Nehru Medical College
Asian Pacific Journal of Tropical Medicine | Year: 2012

Cysticercosis is a common tropical disease. Disseminated form is one of the uncommon manifestations and a rare complication of this disease. We report an immunocompetent patient with disseminated cysticercosis who had involvement of the brain and skeletal muscles giving rise to Herculean appearance. © 2012 Hainan Medical College.


Singh P.K.,Jawahar Lal Nehru Medical College
Iranian Journal of Radiation Research | Year: 2011

The perioperative imaging of a pregnant woman presents a unique challenge to orthopaedics surgeon as concern about the radiation risk to the embryo or fetus. This article highlights effect of radiation exposure on foetus. I would like to discuss about the amount of radiation exposure in a pregnant woman during fluoroscopic guided closed femoral Interlock nailing as radiation has significant cancerous and non cancerous effect on fetus. © 2011, Novim Medical Radiation Institute. All rights reserved.


Bunkar S.K.,Jawahar Lal Nehru Medical College | Singh A.,Jawahar Lal Nehru Medical College | Singh R.P.,Jawahar Lal Nehru Medical College
Journal of Clinical and Diagnostic Research | Year: 2015

Stercoral perforation of the colon is a life threatening condition, due to pressure necrosis by hard fecaloma which, are commonly found in chronic constipated patients. We report the case of a 45-year-old schizophrenic woman, under psychiatric treatment for two years, presenting with a 10-day history of absolute obstipation and distension. On physical examination the patient had signs of generalized peritonitis. Preoperative diagnostic workup gave no clear-cut clues about diagnosis. Emergency laparotomy revealed a single perforation over the antimesentric border of the sigmoid colon with hard fecal matter protruding through perforation margin. A segmental resection of the sigmoid colon with colonic lavage and end to end anastomosis was performed. The patient made an uneventful recovery. We have discussed the diagnostic work-up, and the management of this rare entity. Patient was on antipsychotic, anticholenergic and NSAID’S drugs for long time with longstanding immobilisation and poor oral intake. Association of these etiological factors with chronic constipation which ultimately leads to stercoral perforation have been corroborated. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.


Retrospective study.To note the magnetic resonance imaging (MRI) differences between pathologically proven cases of atypical spinal tuberculosis and spinal metastasis in 40 cases.Spinal tuberculosis, or Potts spine, constitutes less than 1% of all cases of tuberculosis and can be associated with a neurologic deficit. Breast, prostate and lung cancer are responsible for more than 80% of metastatic bone disease cases, and spine is the most common site of bone metastasis. Thus, early diagnosis and prompt management of these pathologies are essential in preventing various complications.We retrospectively reviewed 40 cases of atypical tuberculosis and metastasis affecting the spine from the year 2012 to 2014, with 20 cases each that were proven by histopathological examination. MR imaging was performed on 1.5 T MR-Scanner (Magnetom Avanto, Siemens) utilizing standard surface coils of spine with contrast injection. Chi-square test was used for determining the statistical significance and p-values were calculated.The most common site of involvement was the thoracic spine, seen in 85% cases of metastasis and 65% cases of Potts spine (p=0.144). The mean age of patients with tubercular spine was found to be 40 years and that of metastatic spine was 56 years. The following MR imaging findings showed statistical significance (p<0.05): combined vertebral body and posterior elements involvement, skip lesions, solitary lesion, intra-spinal lesions, concentric collapse, abscess formation and syrinx formation.Tuberculosis should be considered in the differential diagnosis of various spinal lesions including metastasis, fungal spondylodiskitis, sarcoidosis and lymphoma, particularly in endemic countries. Spinal tuberculosis is considered one of the great mimickers of disease as it could present in a variety of typical and atypical patterns, so proper imaging must be performed in order to facilitate appropriate treatment.


PubMed | Jawahar Lal Nehru Medical College
Type: Journal Article | Journal: Journal of bone oncology | Year: 2016

Primary bone lymphoma (PBL) is an uncommon clinical entity and a rare presentation of non-Hodgkins lymphoma. PBL accounts for less than 5% of malignant bone tumors, 4-5% of extra nodal lymphoma and less than 1% of all non-Hodgkins lymphoma. Diffuse large-B-cell lymphoma (DLBCL) accounts for the majority of cases of PBL. The incidence of PBL is so rare that many of its aspects remain unknown. A number of studies have been reported from western countries but only a few reports are available from Asia. Out of 20,000 bone lesions received in our department over 5 years, only 5 cases were primary bone lymphoma; all of which were DLBCL. We report our experience on PBLs with main emphasis on two unusual presentations of this rare tumor.


PubMed | Jawahar Lal Nehru Medical College
Type: Journal Article | Journal: East Asian archives of psychiatry : official journal of the Hong Kong College of Psychiatrists = Dong Ya jing shen ke xue zhi : Xianggang jing shen ke yi xue yuan qi kan | Year: 2016

During and after childbirth women undergo tremendous psychological and biological changes. These biological changes, along with the stress of assuming the new role of mother, make postpartum women vulnerable to various psychiatric disorders including cognitive dysfunction, depression, and anxiety. Such problems are under-reported as they are difficult to identify, especially by caregivers who are more focused on the newborn. The present study aimed to evaluate the prevalence of behaviour problems and cognitive dysfunction during the postpartum period.A cross-sectional study was carried out at the Department of Obstetrics and Gynaecology, Jawahar Lal Nehru Medical College, Ajmer, India. The study sample included 200 consecutive women who came for their first follow-up after childbirth, and 100 healthy and non-pregnant women who served as controls. Cognitive function was assessed using the Standard Mini-Mental State Examination Scale (SMMSE), Brief Cognitive Rating Scale (BCRS), and Trail Making Test Part B (TMT-B). 21-Item Depression Anxiety and Stress Scale was administered to assess depressive and anxiety symptoms.Postpartum women scored poorly on SMMSE, BCRS, and TMT-B compared with non-pregnant women (p < 0.001), whereas subscores of depression, anxiety, and stress were significantly higher (p < 0.001).Women had significantly more cognitive deficits during the postpartum period than their non-pregnant counterparts. The former also had a higher prevalence of depression, anxiety, and stress.

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