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Das A.K.,Post Graduate Institute of Medical Education and Research | Bhansali A.,Jawaharlal Institute of Postgraduate Medical Education & Research | Joshi S.R.,Lilavati Hospital | Joshi P.P.,Indira Gandhi Government Medical College | And 5 more authors.
International Journal of Behavioral Nutrition and Physical Activity | Year: 2014

Background: The rising prevalence of diabetes and obesity in India can be attributed, at least in part, to increasing levels of physical inactivity. However, there has been no nationwide survey in India on physical activity levels involving both the urban and rural areas in whole states of India. The aim of the present study was to assess physical activity patterns across India - as part of the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study.Methods: Phase 1 of the ICMR-INDIAB study was conducted in four regions of India (Tamilnadu, Maharashtra, Jharkhand and Chandigarh representing the south, west, east and north of India respectively) with a combined population of 213 million people. Physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ) in 14227 individuals aged ≥ 20 years [urban- 4,173; rural- 10,054], selected from the above regions using a stratified multistage design.Results: Of the 14227 individuals studied, 54.4% (n = 7737) were inactive (males: 41.7%), while 31.9% (n = 4537) (males: 58.3%) were active and 13.7% (n = 1953) (males: 61.3%) were highly active. Subjects were more inactive in urban, compared to rural, areas (65.0% vs. 50.0%; p < 0.001). Males were significantly more active than females (p < 0.001). Subjects in all four regions spent more active minutes at work than in the commuting and recreation domains. Absence of recreational activity was reported by 88.4%, 94.8%, 91.3% and 93.1% of the subjects in Chandigarh, Jharkhand, Maharashtra and Tamilnadu respectively. The percentage of individuals with no recreational activity increased with age (Trend χ2: 199.1, p < 0.001).Conclusions: The study shows that a large percentage of people in India are inactive with fewer than 10% engaging in recreational physical activity. Therefore, urgent steps need to be initiated to promote physical activity to stem the twin epidemics of diabetes and obesity in India. © 2014 Anjana et al.; licensee BioMed Central Ltd.


Lakdawala M.,Center for Obesity and Diabetes Support | Lakdawala M.,Saifee Hospital | Lakdawala M.,Lilavati Hospital | Bhasker A.,Center for Obesity and Diabetes Support | Bhasker A.,Saifee Hospital
Obesity Surgery | Year: 2010

Background The report submitted is a detailed analysis of the happenings and outcomes of a two day deliberation that was organized in Trivandrum, India on the 9th and 10th August 2009. Methods Asian Consensus Meeting on Metabolic Surgery (ACMOMS) was the first ever meeting of its kind in Asia where 52 professionals involved in the field of bariatric surgery, metabolic surgery, diabetes, and medical research from countries across Asia and the GCC met at Trivandrum, India to vote for and create a new set of guidelines for the Asian genotype, which were different from the NIH guidelines set for bariatric surgery. The aim was to set culturally, geographically, and genetically relevant standards for the management of obesity and metabolic syndrome. Results It is known that Asians have a higher adiposity for a given level of obesity, and this is visceral obesity as compared to other populations. Currently, all over the world and in Asia as well, guidelines set by NIH in 1991 are being followed. Surgeons believe that NIH guidelines need to be revisited and modified. It is in light of these observations that the genesis of ACMOMS took place. At ACMOMS, it was recommended that the NIH guidelines are not suitable for Asians, and the BMI guidelines should be lowered for indication of surgery. Waist or waist-hip ratio must gain significance as compared to BMI alone in Asia. Conclusions The collective recommendations were submitted as a report to the executive committee for approval. As the Asia Pacific region consists of more than half of the world's population, the dire health and economic consequences of this epidemic demand urgent action from the medical fraternity in this region, and we hope that the recommendations will help to review the currently accepted guidelines. © Springer Science+Business Media, LLC 2010.


Mirgh S.P.,Jai Gurudev C.H.S. | Bhave A.A.,Lilavati Hospital
Indian Journal of Hematology and Blood Transfusion | Year: 2016

We report the case of a 29 year old pregnant female who experienced itching with erythematous plaques on prophylactic enoxaparin for recurrent fetal losses. These lesions generalized on rechallenge but erythema and itching gradually resolved after 4 weeks of discontinuation. Cutaneous adverse events with heparin have been reported (Villanueva et al. in Actas Dermosifiliogr 103:816–819, 2012; Neloska et al. in Acta Dermatovenerol Croat 23:223–224, 2015; Maldonado et al. in Clin Exp Dermatol 37:707–711, 2012; Schindewolf et al. in Lancet 380:1867–1879, 2012; Tassava and Warkentin in Am J Hematol 90:747–750, 2015), some specifically with enoxaparin (Villanueva et al. 2012; Neloska et al. 2015). © 2016 Indian Society of Haematology & Transfusion Medicine


Figueiredo A.,Lilavati Hospital | Maheshwari S.,Lilavati Hospital | Goel A.,King College
Journal of Clinical Neuroscience | Year: 2010

A 19-year-old girl presented with symptoms of severe headache and diplopia. Investigations revealed a large and partly calcified lesion in the pineal region. At surgery a large cavernoma was identified and was radically resected. Following surgery, the patient recovered from all her symptoms. Giant cavernomas in the pineal region are rare. The literature on the subject is reviewed. © 2009 Elsevier Ltd. All rights reserved.


De Souza C.E.,Lilavati Hospital | Nisar J.,Gala Eye Hospital | De Souza R.A.,BYL Nair Hospital
Otolaryngology - Head and Neck Surgery (United States) | Year: 2012

This is a case series with chart review from 1997 to 2010 to determine results of endoscopic dacryocystorhinostomy in children. Thirty-seven children underwent removal of the medial wall (RMW) of the lacrimal sac (LS) and 2 had lacrimal stents inserted because they had external fistulae and small cicatrized LS. Parameters of success were (1) resolution of epiphora, (2) no further attacks of dacryocystitis, and (3) patency of neofistula. Of the 37 (95%) children who had RMW of the LS, 34 (92%) were patent after 12 weeks and were considered successful. Three (8%) neofistulae obstructed within 2 weeks and needed revision, and 2 (5%) patients had small cicatrized LS along with fistula and were stented. The fistulae closed down in 4 weeks. However, when the stents were removed 6 weeks later, epiphora returned. The authors' experience reveals that removal of the medial wall of the LS is effective in stopping chronic epiphora. © 2012 American Academy of Otolaryngology - Head and Neck Surgery Foundation.


Aim: To report the patterns and sites of 18-FDG uptake in patients of presumed ocular tuberculosis. Materials and methods: The clinical and investigational findings of 11 patients were reviewed retrospectively. These included 6 males and 5 females with a mean age of 46.2 years. 21 eyes were included in the data analysis. Clinical presentations include 15 eyes with anterior uveitis, 2 eyes with retinal vasculitis, 2 eyes with panuveitis and 2 eyes with multifocal choroidopathy. Results: Two distinct patterns of systemic uptake emerged. Pattern 1: No detectable systemic uptake (4 patients). Pattern 2: Detectable systemic uptake. a. Chest disease only (2 patients). b. Disseminated pattern, uptake seen at multiple sites (4 patients). c. Extrapulmonary only (1 patient). Conclusions: Ocular tuberculosis may often be part of a wider disseminated disease. © 2012 Informa Healthcare USA, Inc.


Kulkarni M.,Lilavati Hospital
Journal of Medical Imaging and Radiation Oncology | Year: 2011

High spatial resolution is one of the major problems in neuroimaging, particularly in cranial and spinal nerve imaging. Constructive interference in steady-state/fast imaging employing steady-state acquisition with phase cycling is a robust sequence in imaging the cranial and spinal nerve pathologies. This pictorial review is a concise article about the applications of this sequence in neuroimaging with clinical examples. © 2011 The Author. Journal of Medical Imaging and Radiation Oncology © 2011 The Royal Australian and New Zealand College of Radiologists.


Aiyangar A.,Lilavati Hospital
The Journal of the Association of Physicians of India | Year: 2010

Mycophenolate (MMF) has arisen as an important addition in the immunosuppression armamentarium. GI disturbances (diarrhea) and bone marrow suppression are its main side effects requiring dose reduction or even withdrawal. The mechanism of diarrhoea is unknown, although some theories have been postulated. We evaluated three of our patients on MMF who came to us with chronic diarhoea. Their evaluation consisted of CBC, stool routine examination, stool culture, endoscopy and biopsy. Histopathologic examination in all three cases showed villous atrophy. All of them improved with discontinuation of MMF and addition of folic acid suggesting that diarrhoea was related to MMF. Since this complication is seen in only a few cases, we can hypothesize that it may be due to lower levels of the enzyme inosine monophosphate dehydrogenase (IMPDH)--the site of action of MMF.


Maniar R.N.,Lilavati Hospital | Singhi T.,Breach Candy Hospital | Rathi S.S.,Jawaharlal Nehru Medical College | Baviskar J.V.,BYL Nair Hospital | Nayak R.M.,Lilavati Hospital
Clinical Orthopaedics and Related Research | Year: 2012

Background: Lateral release of a tight lateral retinaculum in a TKA is intended to correct patellar maltracking but the widely used inside-out technique has associated risks. We describe an alternate stepwise outside-in technique, with titrated release intended to maximize the chance of preserving the superior lateral genicular artery (SLGA). Description of Technique: Patellar maltracking was judged by a no-thumb technique and graded as I and Ia: normal and near normal tracking; II: patella tilted; III: patella subluxed; or IV: patella dislocated. Outside-in release was performed in three progressive steps. Step-1 release was from the midpatella to the upper tibial border, Step-2 release was from the midpatella to the proximal pole of the patella, and Step-3 release was proximal to the superior pole of the patella with sectioning of the SLGA. Methods: We retrospectively reviewed records of 1884 patients operated on between 2002 to 2008. Two hundred five patients (11%) had lateral release performed, and 177 of those 205 patients (86%) were reviewed. Patellofemoral function was assessed clinically by The Knee Society score. Radiographs were examined for patellar tilt, shift, and avascular necrosis. The minimum followup was 22 months (median 48 months; range, 22-105 months). Results: The SLGA was preserved in 155 (76%) patients. At last followup, no patient had patellar maltracking, patellar fracture, or avascular necrosis. Six of 177 (3%) patients had anterior knee pain. Female patients and high-flex components had a higher incidence of release and midvastus arthrotomy had a lower incidence of release. Conclusions: Stepwise release of the lateral retinaculum by an outside-in technique allowed minimum necessary retinacular release, preserving the SLGA in 76% of patients. No complications were seen at followup with functional and radiographic examinations. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. © 2012 The Association of Bone and Joint Surgeons®.


Nair S.,KEM Hospital Campus | Nadkarni A.,KEM Hospital Campus | Warang P.,KEM Hospital Campus | Bhave A.,Lilavati Hospital | And 2 more authors.
European Journal of Clinical Investigation | Year: 2010

Background This study was undertaken to analyse cases of microcytosis, and/or haemolytic anaemia where an unusual peak on HPLC or an abnormal electrophoretic mobility in isolation or along with common β-globin gene defects was found, and to identify the molecular abnormality in them. Patients and methods Investigations included a complete blood count, HPLC analysis, cellulose acetate electrophoresis (pH 8.9), heat stability test and DNA sequencing. Results Five α chain variants were identified. This is the first report of Hb Jackson and Hb O Indonesia in the Indian population. The presence of Hb J Meerut along with Hb E and Hb J Paris I with heterozygous β-thalassaemia are uncommon associations. Hb Sun Prairie would have remained undetected in the heterozygous state. The presence of a homozygous child in the family helped to identify this variant. Conclusions This study emphasizes the need to undertake systematic investigations while screening for the β haemoglobinopathies to identify rare α chain variants in a population. © 2010 Stichting European Society for Clinical Investigation Journal Foundation.

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