Lokmanya Tilak Municipal General Hospital

Sion, India

Lokmanya Tilak Municipal General Hospital

Sion, India
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Parikh D.A.,Lokmanya Tilak Municipal General Hospital | Jain R.A.,Lokmanya Tilak Municipal General Hospital | Lele S.S.,Lokmanya Tilak Municipal General Hospital | Tendolkar B.A.,Lokmanya Tilak Municipal General Hospital
Indian Journal of Anaesthesia | Year: 2017

Background and Aims: Ambu® AuraGain™ (AG) (Ambu, Ballerup, Denmark) is a supraglottic device which has a design facilitating its use as a conduit for intubation. We designed this prospective observational study to assess the ease of AG placement in paralysed patients, determine its position and alignment to the glottis and assess its utility as a conduit for intubation. Methods: One hundred patients, aged 18–60 years, American Society of Anesthesiologists physical status I–II, undergoing elective surgery under general anaesthesia were included in the study. The ease and number of attempts for successful insertion, ease of gastric tube insertion, leak pressures, fibre-optic grade of view, number of attempts and time for tracheal intubation, time for AG removal and complications were recorded. The mean, standard deviation (SD), interquartile range (IQR) and range were calculated. The upper limit of confidence interval for overall failure rate was calculated using Wilson’s score method. Results: AG was successfully inserted in all patients. The mean (SD) time taken for insertion was 17.32 (8.48) s. The median [IQR] leak pressures were 24 [20–28] cm of H2O. Optimal laryngeal view for intubation was obtained in 68 patients. Eighty-eight patients could be intubated in the first attempt. Five patients could not be intubated. The overall failure rate of device was 9%. Conclusion: AMBU® AuraGain™ serves as an effective ventilating aid, but caution is suggested before using it as a conduit for endotracheal intubation. © 2017 Indian Journal of Anaesthesia | Published by Wolters Kluwer – Medknow.


Nasa M.,Lokmanya Tilak Municipal General Hospital | Choksey A.,Lokmanya Tilak Municipal General Hospital | Phadke A.,Lokmanya Tilak Municipal General Hospital | Sawant P.,Lokmanya Tilak Municipal General Hospital
Indian Journal of Gastroenterology | Year: 2013

Background: Antimicrobial resistance has decreased eradication rates for Helicobacter pylori infection worldwide. A sequential treatment schedule has been reported to be effective, but studies published to date were performed in Italy. We undertook this study to determine whether these results could be replicated in India. Methods: A randomized, open-labeled, prospective controlled trial comparing sequential vs. standard triple-drug therapy was carried out at Lokmanya Tilak Municipal General Hospital, Mumbai. Two hundred and thirty-one patients with dyspepsia were randomized to a 10-day sequential regimen (40 mg of pantoprazole, 1 g of amoxicillin, each administered twice daily for the first 5 days, followed by 40 mg of pantoprazole, 500 mg of clarithromycin, and 500 mg of tinidazole, each administered twice daily for the remaining 5 days) or to standard 14-day therapy (40 mg of pantoprazole, 500 mg of clarithromycin, and 1 g of amoxicillin, each administered twice daily). Results: The eradication rate achieved with the sequential regimen was significantly greater than that obtained with the triple therapy. Per-protocol eradication rate of sequential therapy was 92.4 % (95 % CI 85.8-96.1 %) vs. 81.8 % (95 % CI 73.9-87.8 %) (p = 0.027) for standard drug therapy. Intention-to-treat eradication rates were 88.2 % (95 % CI 80.9-93.0 %) vs. 79.1 % (95 % CI 71.1-85.4 %), p = 0.029, respectively. The incidence of major and minor side effects between therapy groups was not significantly different (14.6 % in the triple therapy group vs. 23.5 % in sequential group, p = 0.12). Follow up was incomplete in 3.3 % and 4.7 % patients in standard and sequential therapy groups, respectively. Sequential therapy includes one additional antibiotic (tinidazole) that is not contained in standard therapy. Conclusions: Sequential therapy was significantly better than standard therapy for eradicating H. pylori infection. © 2013 Indian Society of Gastroenterology.


Zaki S.A.,Lokmanya Tilak Municipal General Hospital | Lad V.,Lokmanya Tilak Municipal General Hospital
Journal of Pediatric Neurosciences | Year: 2011

Sturge Weber syndrome is characterized by unilateral facial nevus with a tram track appearance on CT scan. However different variants have been described. We report one such variant in a 14 months old child with bilateral facial nevus and bilateral curvilinear calcification. There was also global development delay and early onset of seizures reflecting the severe bilateral cortical changes.


Ducrotte P.,University of Rouen | Sawant P.,Lokmanya Tilak Municipal General Hospital | Jayanthi V.,India.gov.in
World Journal of Gastroenterology | Year: 2012

AIM: To assess the symptomatic efficacy of Lactobacillus plantarum 299v (L. plantarum 299v) (DSM 9843) for the relief of abdominal symptoms in a large subset of irritable bowel syndrome (IBS) patients fulfilling the Rome III criteria. METHODS: In this double blind, placebo-controlled, parallel-designed study, subjects were randomized to daily receive either one capsule of L. plantarum 299v (DSM 9843) or placebo for 4 wk. Frequency and intensity of abdominal pain, bloating and feeling of incomplete rectal emptying were assessed weekly on a visual analogue scale while stool frequency was calculated. RESULTS: Two hundred and fourteen IBS patients were recruited. After 4 wk, both pain severity (0.68 + 0.53 vs 0.92 + 0.57, P < 0.05) and daily frequency (1.01 + 0.77 vs 1.71 + 0.93, P < 0.05) were lower with L. plantarum 299v (DSM 9843) than with placebo. Similar results were obtained for bloating. At week 4, 78.1 % of the patients scored the L. plantarum 299v (DSM 9843) symptomatic effect as excellent or good vs only 8.1 % for placebo (P < 0.01). CONCLUSION: A 4-wk treatment with L. plantarum 299v (DSM 9843) provided effective symptom relief, particularly of abdominal pain and bloating, in IBS patients fulfilling the Rome III criteria. © 2012 Baishideng.


Zaki S.,Lokmanya Tilak Municipal General Hospital
Indian Journal of Pharmacology | Year: 2013

Terlipressin, an analog of the natural hormone arginine-vasopressin, is a splanchnic constrictor that is used to control variceal bleeding in portal hypertension. It has a very good safety profile compared to vasopressin. Although rare, adverse effects such as hyponatremia and seizure can occur. We describe a 7-year-old male child who developed hyponatremia induced by infusion of terlipressin which resulted in a generalized seizure. After withdrawal of terlipressin, the serum sodium level became normal. Through this case, we emphasize the importance of monitoring patient′s electrolyte levels during the course of terlipressin therapy.


Zaki S.A.,Lokmanya Tilak Municipal General Hospital | Lad V.,Lokmanya Tilak Municipal General Hospital | Shanbag P.,Lokmanya Tilak Municipal General Hospital
Annals of Indian Academy of Neurology | Year: 2012

In patients with central nervous system disease, life-threatening hyponatremia can result from either the syndrome of inappropriate secretion of antidiuretic hormone or cerebral salt wasting. Clinical manifestations of the two conditions may be similar, but their pathogeneses and management protocols are different. Cerebral salt wasting syndrome is a disorder in which excessive natriuresis and hyponatremia occurs in patients with intracranial diseases. We report a 6-month-old girl with CSWS associated with tuberculous meningoencephalitis. She was diagnosed as having CSWS on the basis of hypovolemia, polyuria, natriuresis, and the relatively high level of fractional excretion of uric acid. Aggressive replacement of urine salt and water losses using 0.9% or 3% sodium chloride was done. Fludrocortisone was started at 0.1 mg twice daily on the seventh day of admission and was continued for 17 days.


Zaki S.A.,Lokmanya Tilak Municipal General Hospital | Lad V.,Lokmanya Tilak Municipal General Hospital
Indian Journal of Pharmacology | Year: 2011

Piperacillin/tazobactam is a commonly prescribed antibiotic and is generally considered safe. We report a case of a 2-year-old girl who developed hypokalemic metabolic alkalosis and bradycardia after receiving intravenous piperacillin-tazobactam for bronchopneumonia. Upon withdrawal of the drug, serum potassium normalized in 2 days. Hypokalemia is a serious adverse effect of piperacillin-tazobactam and should be suspected while treating patients with this drug. Early recognition and prompt withdrawal of the drug will result in lesser morbidity.


Zaki S.A.,Lokmanya Tilak Municipal General Hospital | Shanbag P.,Lokmanya Tilak Municipal General Hospital
Annals of Tropical Paediatrics | Year: 2011

Long considered a benign infection, Plasmodium vivax is now increasingly recognised as a cause of severe and fatal malaria. Various atypical presentations of vivax malaria have been reported. This report highlights the occurrence of acute glomerulonephritis in a 7-year-old girl who presented with fever and vomiting. Peripheral smear examination demonstrated ring forms of P. vivax. OptiMAL test was positive for P. vivax and negative for Plasmodium falciparum. She was managed with antimalarial and antihypertensive drugs and made an uneventful recovery. © W. S. Maney & Son Ltd 2011.


Gundre N.P.,Lokmanya Tilak Municipal General Hospital | Iyer S.P.,Lokmanya Tilak Municipal General Hospital | Subramaniyan P.,Lokmanya Tilak Municipal General Hospital
Updates in Surgery | Year: 2012

Most patients who come to a general hospital in a developing country are poor. The most important prohibiting factor for use of polypropylene mesh in hernia repair is its exorbitant cost. Hence, research workers have been on the lookout for an equally effective but economically affordable mesh. Worldwide, surgical repair of inguinal hernia is the most common general surgery procedure performed at the present. Lifetime risk of groin hernia is 15% in males and 5% in females. Most of the patients who visit a general hospital are from either lower middle class or poor socioeconomic strata. The most important prohibiting factor for use of polypropylene mesh in hernia repair for the common man is its exorbitant cost. The aim of this study is to document the feasibility, safety and cost-effectiveness of the use of polyethylene mesh. A single blind, prospective, randomized controlled study, comparing 35 patients of two groups was conducted in a tertiary teaching hospital over a period of 5 years. The patients in both groups underwent inguinal hernioplasty, and were administered similar antibiotics and analgesics. The postoperative course with regard to pain, seroma formation, infection, hospital stay, recurrence and scar quality was evaluated and compared. Statistical analysis was performed with Chi square test. The properties of both meshes were the same with respect to ease of handling, pain score, seroma formation, infection rate, resumption of daily activities, scar quality and mesh rejection. Recurrence rate was zero for both groups. Polyethylene mesh was 2,808 times cheaper than the commercially available polypropylene mesh. This study proved the safety, simplicity, efficacy and cost-effectiveness of polyethylene mesh for inguinal hernia meshplasty, insuring economical, accessible health care for the financially weak section of the population. © 2011 Springer-Verlag.


Palkar A.V.,Lokmanya Tilak Municipal General Hospital | Pillai S.,Lokmanya Tilak Municipal General Hospital | Rajadhyaksha G.C.,General Hospital
Indian Journal of Nephrology | Year: 2011

We report a 58-year-old woman who presented with acute quadriparesis, bulbar weakness, atrial fibrillation, ventricular ectopics, and distal renal tubular acidosis with severe hypokalemia. She recovered completely on potassium and alkali supplementation. The patient also had hypergammaglobulinemia with probable primary Sjogren syndrome.

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