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Shenoy P.,Lokmanya Tilak Municipal General Hospital and Medical College
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2014

Caroli's syndrome (CS) is a rare congenital disorder characterized by multiple segmental cystic or saccular dilatations of the intrahepatic bile ducts and congenital hepatic fibrosis. We report a 9-year-old boy who was diagnosed with CS and autosomal recessive poly-cystic kidney disease. On screening, his 5-month-old asymptomatic sister had multiple dilated biliary radicals with multiple bilateral renal cystic lesions. Both the patient and the affected sibling have been advised regular follow-up for monitoring the progression of the disease. In conclusion, patients with CS should be screened for renal cystic lesions and vice versa even if they are asymptomatic. Also, as the disease is inherited in an autosomal recessive manner, it is important to screen family members for early diagnosis and management.

Sundar U.,Lokmanya Tilak Municipal General Hospital and Medical College
The Journal of the Association of Physicians of India | Year: 2010

Gitelman' syndrome, although a relatively frequent cause of chronic hypokalemia in adults, is rarely diagnosed correctly. It is frequently confused with overt diuretic abuse or Bartter's syndrome. We describe a 60 year man with 2 year history of recurrent paralytic ileus attributed to recurrent hypokalemia. Investigations in this patient revealed hypokalemia, metabolic alkalosis, hypocalciurea, and hypomagnesemia a tetrad diagnostic of Gitelman's syndrome. The peculiar clinical features of this condition and its management are discussed.

Sundar U.,Internal Medicine and Neurology services | Shaunbhag P.,Paediatrics | Lakkas Y.,Internal Medicine and Neurology services | Shrivastava M.,Internal Medicine and Neurology services | And 3 more authors.
Journal of Association of Physicians of India | Year: 2010

The association of muscle tyrosine kinase (Musk) antibody with recurrent bulbar weakness in acetylcholine receptor antibody (Ach-r Ab) negative myasthenia gravis (MG) has been well documented. We describe 2 patients, a middle aged man and a 9 year old girl, both seronegative for Ach r antibody who had recurrent bulbar weakness and MUSK antibody positivity. Patients made a full recovery from the acute episode with intravenous immunoglobulin(IV Ig) therapy. the peculiar clinical features of this condition and its management are discussed. © JAPI.

Zaki S.,Lokmanya Tilak Municipal General Hospital and Medical College | Shenoy P.,Lokmanya Tilak Municipal General Hospital and Medical College
Indian Journal of Pharmacology | Year: 2011

We report a 5-year-old boy who developed optic neuritis as a paradoxical reaction to anti-tuberculous therapy. Steroids were re-started in the patient with gradual recovery of his vision. The case emphasizes the importance of recognizing paradoxical reactions in patients on anti-tuberculous therapy. Prompt recognition and treatment of such reactions will reduce the associated morbidity.

Nair A.G.,Advanced Eye Hospital and Institute | Nair A.G.,Lokmanya Tilak Municipal General Hospital and Medical College | Ali M.J.,L V Prasad Eye Institute
Indian Journal of Ophthalmology | Year: 2015

Dacryocystorhinostomy (DCR) is the procedure of choice in patients with epiphora due to primary acquired nasolacrimal duct obstruction. The evolution of surgical tools, fiber-optic endoscopes, effective anesthesia techniques, and the adjunct use of antimetabolites intraoperatively; namely mitomycin-C (MMC) have significantly contributed to the advancement of DCR surgery. MMC is a systemic chemotherapeutic agent derived from Streptomyces caespitosus that inhibits the synthesis of DNA, cellular RNA, and protein by inhibiting the synthesis of collagen by fibroblasts. Even the cellular changes in the human nasal mucosal fibroblasts induced by MMC at an ultrastructural level have been documented. There, however, seems to be a lack of consensus regarding MMC: The dosage, the route of delivery/application, the time of exposure and subsequently what role each of these variables plays in the final outcome of the surgery. In this review, an attempt is made to objectively examine all the evidence regarding the role of MMC in DCR. MMC appears to improve the success rate of DCR.

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