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Pandey D.,Lady Hardinge Medical College New Delhi | Verma A.,Lady Hardinge Medical College New Delhi | Akhtar A.,Lady Hardinge Medical College New Delhi | Arsia A.,Lady Hardinge Medical College New Delhi | Singh N.,Lady Hardinge Medical College New Delhi
Journal of Clinical and Diagnostic Research | Year: 2015

Malignant Peripheral Nerve Sheath Tumours (MPNST) arises from a peripheral nerve or exhibit nerve sheath differentiation on histology. Proximal portions of the upper and lower extremities and the trunk are the most common sites of occurrence. Around 50% are associated with Neurofibromatosis Type 1 (NF1) with incidence of two to five per cent in patients with NF1. The estimated incidence in general population without NF1 is 0.0001% of which gastrointestinal MPNST are extremely rare. A 45-year-old lady without pathological antecedent for NF1 was admitted with pain in right lower abdomen and multiple episodes of vomiting for 3 months. Preoperatively intussusception was diagnosed in the small bowel with USG and CECT abdomen showing characteristic target sign. On laparotomy Ileo-ileal intussusception (proximal ileum telescoping into distal ileum) was found 2 feet proximal to ileo-caecal junction with surrounding inflammed mesentery and presence of intraluminal tumour as lead point. Resection of involved segment of ileum along with its mesentery was done followed by ileo-ileal anastomosis. Histopathology was suggestive of high grade MPNST. Postoperative course and follow up for last 10 month is uneventful. This case is unique in terms of a rare tumour presenting with unusual complication and only one case had been reported so far in western literature. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.


PubMed | Lady Hardinge Medical College New Delhi
Type: Journal Article | Journal: Sexual medicine | Year: 2014

Pharmacists play a key role while dispensing over-the-counter emergency contraception (EC) to the client.The study aims to evaluate the knowledge and over-the-counter services provided by the pharmacists in Delhi.A prestructured questionnaire-based survey was conducted in Delhi, the capital city of India.Only 60 out of 85 pharmacies approached agreed to participate in the study. Number of packs sold in a month per pharmacy varied from 2 to 500 packs/month. Sixty-two percent of the pharmacists claimed that majority of the clients repeated use during the same month. Only 18% of the clients were referred by doctors while 82% directly approached the pharmacists. Nearly one third of the clients were adolescents. Sixty-seven percent of the pharmacists had adequate knowledge about EC. Only 3.3% asked about the last menstrual period or the time elapsed since the last unprotected intercourse. No pharmacist inquired whether there were one or multiple unprotected acts of intercourse, if any regular contraceptive method was being used, or explored the reason for EC intake. There were 91.7% who explained the dosage schedule to clients. Only half of them explained that the client may experience side effects. None of the pharmacists advised their clients for a sexually transmitted disease screening, and 35% counseled the clients regarding regular contraception.Improving the quality of services provided by the pharmacists can clear misconceptions of the clients and promote subsequent regular contraception along with precautions to avoid sexually transmitted diseases. Mishra A and Saxena P. Over-the-counter sale of emergency contraception: A survey of pharmacists in Delhi. Sex Med 2013;1:16-20.

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