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Agrawal M.B.,Lokmanya Tilak Municipal Medical College | Awad N.T.,Lokmanya Tilak Municipal Medical College
Journal of Clinical and Diagnostic Research | Year: 2017

Introduction: The cardiac effect of different pulmonary functions, six minute walk distance, arterial blood gases and saturation in interstitial lung disease is not much known. So this study, a tertiary care hospital experience that entails to know the various factors in pulmonary hypertension mentioned above causing pulmonary hypertension and their correlation with pulmonary hypertension. Aim: To study the correlation of pulmonary hypertension in patients with Interstitial Lung Disease (ILD) with spirometry and six minute walk test. Materials and Methods: All consecutive patients with confirmed diagnosis of ILD taken over a period of 1½year in tertiary care hospital. Six minute walk test and spirometry were performed as per the American Thoracic Guidelines. Percent predicted 6 minute walk distance was calculated using Enright et al., and Indian reference equation. Pulmonary hypertension was diagnosed using 2-D echo. The spirometry variables and six minute walk test were then correlated with the mean pulmonary artery pressure. results: There were 75 patients. About 66.66% had pulmonary hypertension on 2-D echo. The mean% predicted six minute walk distance as per the Indian reference equation, pre- and post- exercise PaO2 as well as desaturation had a significant correlation with pulmonary hypertension. Spirometry variables Forced Expiratory Volume in First Second (FEV1) and Forced Vital Capacity (FVC) did not correlate with pulmonary hypertension. conclusion: Thus, the six minute walk test correlated significantly with pulmonary hypertension while spirometry did not. © 2017, Journal of Clinical and Diagnostic Research. All rights reserved.


Shah N.,Lokmanya Tilak Municipal Medical College | De Sousa A.,Lokmanya Tilak Municipal Medical College
Mens Sana Monographs | Year: 2015

The family is an integral part of one's life. It is very essential that every individual employed or unemployed invests time therein. The family is a source of support and growth for an individual, and the lack of family support or loneliness may be a causative factor in the genesis of psychiatric disorders, especially depression. In India, family plays a paramount role when it comes to mental health of the individual. Tips on how one should invest time in one's family along with the role of a family in one's personal and social structure are discussed.


De Sousa D.,Lokmanya Tilak Municipal Medical College | De Sousa A.,Desousa Foundation
Mens Sana Monographs | Year: 2015

Indian womanhood today is at crossroads. The present paper discusses the status of Indian womanhood and its psychological underpinnings. It discusses how Indian women have suffered at the hands of their families and society leaving no path but to succumb to psychiatric illness. The role of mental health professionals and family members in supporting and promoting growth and development of the Indian woman is outlined.


Shrivastava A.,Lawson Health Research Institute | Desousa A.,Lokmanya Tilak Municipal Medical College
Indian Journal of Psychiatry | Year: 2016

Understanding of psychopathology of mental disorder is evolving, particularly with availability of newer insight from the field of genetics, epigenetics, social, and environmental pathology. It is now becoming clear how biological factors are contributing to development of an illness in the face of a number of psychosocial factors. Resilience is a psychobiological factor which determines individual's response to adverse life events. Resilience is a human capacity to adapt swiftly and successfully to stressful/traumatic events and manage to revert to a positive state. It is fundamental for growth of positive psychology which deals with satisfaction, adaptability, contentment, and optimism in people's life. Of late, there has been a paradigm shift in the understanding of resilience in context of stress risk vulnerability dimension. It is a neurobiological construct with significant neurobehavioral and emotional features which plays important role in deconstructing mechanism of biopsychosocial model of mental disorders. Resilience is a protective factor against development of mental disorder and a risk factor for a number of clinical conditions, e.g. suicide. Available information from scientific studies points out that resilience is modifiable factor which opens up avenues for a number of newer psychosocial as well as biological therapies. Early identification of vulnerable candidates and effectiveness of resilience-based intervention may offer more clarity in possibility of prevention. Future research may be crucial for preventive psychiatry. In this study, we aim to examine whether resilience is a psychopathological construct for mental disorder.


Nanavati A.J.,Kb Bhabha Municipal Hospital | Nagral S.,Kb Bhabha Municipal Hospital | Prabhakar S.,Lokmanya Tilak Municipal Medical College
National Medical Journal of India | Year: 2014

Fast-track surgery or ‘enhanced recovery after surgery’ or ‘multimodal rehabilitation after surgery’ is a form of protocolbased perioperative care programme. It is an amalgamation of evidence-based practices that have been proven to improve patient outcome independently and exert a synergistic effect when applied together. The philosophy is to treat the patient’s pathology with minimal disturbance to the physiology. Several surgical subspecialties have now adopted such protocols with good results. The role of fast-track surgery in colorectal procedures has been well demonstrated. Its application to other major abdominal surgical procedures is not as well defined but there are encouraging results in the few studies conducted. There has been resistance to several aspects of this programme among gastrointestinal and general surgeons. There is little data from India in the available literature on the application of fast-tracking in gastrointestinal surgery. In a country such as India the existing healthcare structure stands to gain the most by widespread adoption of fast-track methods. Early discharge, early ambulation, earlier return to work and increased hospital efficiency are some of the benefits. The cost gains derived from this programme stand to benefit the patient, doctor and government as well. The practice and implementation of fast-track surgery involves a multidisciplinary team approach. It requires policy formation at an institutional level and interdepartmental coordination. More research is required in areas like implementation of such protocols across India to derive the maximum benefit from them. © The National Medical Journal of India 2014.


Chavan S.V.,Lokmanya Tilak Municipal Medical College | Maitra A.,National Health Research Institute | Roy N.,Bhabha Atomic Research Center | Chavan P.R.,MGM Medical College
Indian Journal of Medical Research | Year: 2014

Background & objectives: Wide variability in serum prostate specific antigen (PSA) levels exists in malignant conditions of the prostate. PSA is expressed in normal range in 20 to 25 per cent of prostate cancer cases even in presence of high grade Gleason score. This study was aimed to assess the influence of genetic variants exhibited by PSA and androgen receptor (AR) genes towards the variable expression of PSA in prostate cancer. Methods: Pre-treatment serum PSA levels from 101 prostate cancer cases were retrieved from medical record. PSA genotype analysis in promoter region and AR gene microsatellite Cytosine/Adenine/Guanine (CAG) repeat analysis in exon 1 region was performed using DNA sequencing and fragment analysis techniques. Results: A total of seven single nucleotide polymorphisms (SNPs) in the PSA promoter region were noted. Only two SNPs viz., 158G/A (P<0.001) in the proximal promoter region and -3845G/A (P<0.001) in enhancer region showed significant association with serum PSA levels. The carriers of homozygous GG genotype (P<0.001) at both of these polymorphic sites showed higher expression of PSA whereas homozygous AA genotype (P<0.001) carriers demonstrated lower PSA levels. The combination effect of PSA genotypes along with stratified AR CAG repeats lengths (long, intermediate and short) was also studied. The homozygous GG genotype along with AR long CAG repeats and homozygous AA genotype along with AR short CAG repeats at position -3845 and -158 showed strong interaction and thus influenced serum PSA levels. Interpretation & conclusions: The genetic variants exhibited by PSA gene at positions -3845G/A and -158G/A may be accountable towards wide variability of serum PSA levels in prostate cancer. Also the preferential binding of G and A alleles at these polymorphic sites along with AR long and short CAG repeats may contribute towards PSA expression.


Bawa M.S.,SBH Government Medical College | Srivastav M.,Lokmanya Tilak Municipal Medical College
Indian Journal of Occupational and Environmental Medicine | Year: 2013

Background: Work hazards have been a major cause of concern in driving industry especially in taxi drivers. This study integrates the various factors that influence physical and emotional well-being of taxi drivers into the theoretical model that shows that the work environment, stress and personality characteristics directly influence taxi drivers′ health. Objective: The aim of the following study is to study the relative and combined influence of work environment, personality characteristics and stress on the health of taxi drivers. Meterials and Methods: The present study is cross-sectional (descriptive) study taxi drivers in Mumbai. They are selected using multistage random sampling method. Calculated sample size is 508. Data produced after the survey is analyzed using IBM SPSS 16.0 software. Results: Nearly 65% of taxi drivers belonged to middle-age group of 21-40 years of age. Majority (59%) of taxi drivers belonged to the lower upper socio-economic class. 70% of taxi drivers worked for more than 8 h daily. 63% gave the history of one or more addictions. 52% taxi drivers had type B1 personality, only 6% had stress prone and aggressive type A1 personality. Traffic congestion (67.1%) was reported as the leading stressor followed by narrow bottle neck roads (43%), too many speed breakers (41%), rude gestures and behavior by other drivers (42%) and bad weather (36%). Nearly 86% taxi drivers had one or more symptoms of morbidities. Gastrointestinal symptoms predominated followed by musculoskeletal symptoms and depression. Conclusion: Socio-demographic attributes, work environment, stress and personality significantly influence physical and psychological morbidities in taxi drivers.


Kalra G.,Lokmanya Tilak Municipal Medical College | Kalra G.,Sion General Hospital
International Journal of Culture and Mental Health | Year: 2012

Indian society has been tolerant of diverse sexual identities and sexual behaviors as is evident from its mythologies and ancient scripts like the Kamasutra. The transgendered hijra community has evolved to form a unique subculture within Indian society, existing alongside the ubiquitous heterosexual family. This subculture has been clandestine about its customs and lifestyle, but the scene is changing. Although awareness about HIV-AIDS issues in this community is increasing both among the community members and the health professionals, the same cannot be said about mental health issues. This article highlights some of the important aspects of their lives such as their social structure and attaining of Nirvan (emasculation, not to be confused with nirvana) that may be important for the mental health professionals working with such individuals and highlights the dearth of research data regarding the same. © 2012 Copyright Taylor and Francis Group, LLC.


Sivasubramanian M.,Humsafar Trust | Anand V.,Humsafar Trust | Row-Kavi A.,Humsafar Trust | Jerajani H.R.,Lokmanya Tilak Municipal Medical College
International Journal of Public Health | Year: 2010

Objectives: The present study compared the sexual behaviours of married and unmarried men, in Mumbai, India, who have sex with men. Methods: We conducted a cross-sectional analysis (comparing socio-demographic, behavioural and clinical data) of 88 married and 423 unmarried MSM. Results: Even though MSM are single at younger ages, they are more likely to be married later in life and carry their risky sexual behaviours to this changed social milieu. Conclusions: Married MSM had high-risk behaviours with both men and women; they form an important intervention group for HIV prevention. The interventions will not only reduce the transmission in the male-to-male sexual group, but will also have an effect on the male-to-female transmission of HIV. © Swiss School of Public Health 2010.


PubMed | Lokmanya Tilak Municipal Medical College
Type: Journal Article | Journal: Urology annals | Year: 2017

We present a rare case of indirect vesicovaginal fistula (VVF) in a patient with small capacity bladder. The fistula was between abdominal pseudocyst (APC) arising from bladder and vagina - and hence, an indirect VVF. A 35-year-old female had a history of emergency obstetric hysterectomy with iatrogenic bladder injury. Postoperatively, the patient developed VVF and large APC. Patients micturating cystourethrogram was suggestive of small capacity bladder with bilateral Grade IV vesicoureteral reflux with a well-defined APC arising from superior surface of bladder to L4-L5 lumbar vertebrae. Large APC arising from bladder and associated with an indirect VVF is very rare, and to the best of our knowledge, this is the first case reported in literature. The patient was successfully managed with exploratory laparotomy and excision of fistula tract and pseudocyst, adhesiolysis, and ileal augmentation cystoplasty. Multiple intraoperative adhesions should be suspected in APC. We would like to conclude that ileal augmentation cystoplasty is a safe procedure in a case of VVF with APC and small capacity bladder.

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