Navi Mumbai, India
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Gopinath S.,MGM Hospital | Vijayakumari S.,MGM Hospital
International Journal of Pharmacy and Pharmaceutical Sciences | Year: 2011

Geriatrics is the branch of general medicine concerned with the clinical, preventive, remedial and social aspects of illness in the elderly. The prevalence of many disease increases with advancing age and as a result, elderly population often suffer from multiple co-existing conditions. The main objective of our study was to assess the polypharmacy and inappropriate medication usage in geriatric population. The prospective study was carried out in a multispecialty private teaching hospital at Coimbatore over a period of 9 months. The total number of patients admitted in the study site during the period of 850 patients. Among them 170 patients who were had aged > 65 years. Our study investigate that most predominant age group was young old 65-74 years. The average number of drugs been prescribed was found to be 7.47. Antibiotics were the commonly prescribed medicine with 62.35 %, whereas 95.88 % of the prescriptions were classified as major polypharmacy. Moreover 45.3 % of the prescriptions from the overall population contain inappropriate medications. Our findings reported that, thirteen drugs which has to be avoided by beers criteria 2002. In addition to that Propoxyphene, Amitriptyline, NSAIDS was found to be prescribed often in general medicine followed by diazepam and lorazepam by pulmonology and Amidorane by cardiology departments whereas inappropriateness was very high in a General medicine. Our article suggests that current practice in our hospital associated with greater polypharmacy and irrational use of drugs. In future, multidisciplinary approach, steps to be taken for rational drug use in geriatric population.


Mohanty J.,Mgm Medical College | Prasad S.,Mgm Hospital
Bangladesh Journal of Medical Science | Year: 2013

Nerve sheath tumors of gastrointestinal tract are rare and occurs more frequently as systemic manifestations of generalized neurofibromatosis type-1(NF-1).In neurofibromatosis-1 lesions may be scattered or solitary tumor. Occasionally,such tumors may be the initial presenting feature of NF-1.Rarely,cases of isolated nerve sheath tumor of small intestine presenting with bleeding and obstruction have been documented. We report a 19years male presenting with nerve sheath tumor of jejunum in acute abdomen. His investigations show no features of NF-1.


PubMed | MGM Hospital, Lokmanya Tilak Municipal Medical College and General Hospital and Jawaharlal Nehru Medical College
Type: Journal Article | Journal: Journal of pediatric neurosciences | Year: 2016

Hyponatremia has long been recognized as a potentially serious metabolic consequence of tuberculous meningitis (TBM) occurring in 35-65% of children with the disease. The syndrome of inappropriate antidiuretic hormone (SIADH) secretion has for long been believed to be responsible for the majority of cases of hyponatremia in TBM. Cerebral salt wasting syndrome (CSWS) is being increasingly reported as a cause of hyponatremia in some of these children.This study was done to determine the frequency and causes of hyponatremia in children with TBM.Children with newly diagnosed TBM admitted over a 2-year period (January 2009 to December 2010) were included. All patients received anti-tubercular therapy, mannitol for cerebral edema, and steroids. Patients were monitored for body weight, urine output, signs of dehydration, serum electrolytes, blood urea nitrogen, serum creatinine, and urinary sodium. Hyponatremia was diagnosed if the serum sodium was <135 mEq/L. CSWS was diagnosed if there was evidence of excessive urine output, volume depletion, and natriuresis in the presence of hyponatremia. The outcome in terms of survival or death was recorded.Twenty-nine of 75 children (38.7%) with TBM developed hyponatremia during their hospital stay. In 19 patients, hyponatremia subsided after the discontinuation of mannitol. Ten patients with persistent hyponatremia had CSWS. There were no patients with SIADH.CSWS is an important cause of hyponatremia in children with newly diagnosed TBM. In our patients, it was more commonly seen than SIADH.


Tambe S.,University of Bern | Tambe S.,MGM Hospital | Hafliger S.,University of Bern | Borradori L.,University of Bern
Expert Review of Dermatology | Year: 2013

Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disease associated with autoantibodies directed against two components of junctional adhesion complexes in stratified epithelia, BPAG2 and BPAG1-e. BP typically develops in the elderly and manifests with widespread eczematous, urticated and bullous lesions. In up to 20% of the affected patients, obvious blistering is lacking and the clinical features of BP are misleading and closely mimic a variety of other inflammatory conditions. Diagnosis of BP, which should be rather called cutaneous pemphigoid, relies on direct immunofluorescence microscopy studies to detect tissue-bound IgG and/or C3 immune deposits along the epidermal basement membrane zone. Here, the clinical presentations of BP and the diagnostic algorithm with the immunopathological studies available to classify affected patients are reviewed. Finally, the need for widely accepted criteria for the classification of BP patients is emphasized, since in a number of patients with features characteristic for BP, the results of the immunopathological studies are not conclusive or are incomplete. © 2013 Informa UK Ltd.


PubMed | Mgm Hospital and Sri Venkateswara College of Engineering
Type: Journal Article | Journal: Indian journal of psychological medicine | Year: 2016

Dissociative fugue is rare entity to encounter with possible differentials of epilepsy and malingering. It is one of the dissociative disorders rarely seen in clinical practice more often because of the short lasting nature of this condition. This might also be because of organized travel of the individuals during the episodes and return to their families after the recovery from episodes. This is a case description of a patient who has experienced total three episodes of dissociative fugue. The patient has presented during the third episode and two prior episodes were diagnosed as fugue episodes retrospectively based on the history. Planned travel in this case by the patient to a distant location was prevented because of early diagnosis and constant vigilance till the recovery. As in this case, it may be more likely that persons with Dissociative fugue may develop similar episodes if they encounter exceptional perceived stress. However, such conclusions may require follow-up studies.


Kumar S.V.,MGM Hospital | Nagesh A.,MGM Hospital | Leena M.,MGM Hospital | Shravani G.,MGM Hospital | Chandrasekar V.,NTR University of Health Sciences
Journal of Natural Science, Biology and Medicine | Year: 2013

Objective: We sought to evaluate the incidence of metabolic syndrome and non-metabolic syndrome among type 2 diabetic patients attending the diabetic outpatient clinic at tertiary care hospital, Warangal. Materials and Methods: A cross-sectional study was conducted in a period of 6 months from January 2011 to June 2011. The study group consisted of 75 type 2 diabetic patients. They were screened for hypertension, hyperlipidemia, obesity, and clinical characteristics, and other co-morbidities were recorded. Metabolic syndrome diagnosis was made as per ATP III guidelines. Results: The prevalence of metabolic syndrome was significant in men (54.8%) compared to women (45.2%). Incidence of metabolic syndrome was found to be more in normal weight patients (43.56%). Low high density lipoprotein (HDL) levels were observed in both rural (90.63%) and urban (95.65%) patients with metabolic syndrome, followed by increase in waist circumference. The mean HDL level was found to be 23.77 mg/dl. Patients in the age group 51-60 years were found to be more affected with metabolic syndrome. Sedentary household female patients (58.3%) and illiterates (41.8%) were suffering from metabolic syndrome. Patients with metabolic syndrome had been suffering with diabetes (duration of diabetes) from 1 to 5 years. In summary, this cross-sectional study characterizes the metabolic and non-metabolic syndromes of type 2 diabetes patients living in Telangana regions, using ATP III guidelines, and generates a biological resource that enables further investigation of numerous hypotheses related to genetic exposure of both in a population. Conclusion: These results suggest that higher prevalence of metabolic syndrome was observed in non-obese male patients and was significantly associated with aging. Nevertheless, further studies are required to confirm the metabolic syndrome in larger population.


Pandey A.,MGM Hospital | Bandivdekar K.,MGM Hospital
Indian Journal of Ophthalmology | Year: 2012

We present a case of a Human Immunodeficiency Virus (HIV) positive patient who was referred for retinal evaluation to rule out ophthalmic manifestations of Acquired Immunodeficiency Syndrome (AIDS). She complained of some disturbance in vision in both eyes. Fundus examination showed no abnormality. Perimetry, done to rule out optic nerve pathology, showed a left homonymous hemianopia. Magnetic Resonance Imaging (MRI) scan showed features of Progressive Multifocal Leukoencephalopathy (PML). She had no other neurological symptoms or signs.


Vijayakumar S.,Mahatma Gandhi Memorial Hospital | Fareedullah M.,Mahatma Gandhi Memorial Hospital | Ashok Kumar E.,MGM Hospital | Mohan Rao K.,MGM Hospital
Cardiovascular Toxicology | Year: 2011

Organophosphate (OP) compounds are widely used in different applications including agriculture. The widespread use of OP insecticides, however, brings high risks of severe health problems. Besides occupational poisoning in industrial production and agricultural application, instances of acute organophosphate poisoning (OPP) also include suicide, homicide, and accidental overdose. Cardiovascular manifestations frequently accompany exposure to these organophosphorus compounds, but their exact nature is not fully elucidated. In this study, we evaluated 20 patients who presented to our emergency department with organophosphorus (OP) poisoning and discussed their associated electrocardiographic (ECG) abnormalities. Over 3 months, 20 patients with OP poisoning were included in this prospective study. ECG analysis included the rate, ST-T abnormalities, conduction defects, and measurement of PR and "QTc" intervals. Our results show that 12 patients were having prolonged QTc interval i.e.; >0.43 s. Eight patients were having mild elevated ST segment and low-amplitude "T" waves. Most of the patients have shown increased heart rate, where as some has shown decreased value. From this study, we conclude that acute organophosphorus poisoning is associated with ventricular arrhythmias, tachycardia and bradycardia, and attributes mild myocardial ischemia. © 2011 Springer Science+Business Media, LLC.


Suryawanshi P.,MGM Hospital | Khan A.Q.,MGM Hospital | Jatal S.,MGM Hospital
International Journal of Surgery Case Reports | Year: 2011

Context: Primary hydatid disease of the pancreas is very rare and even rarer to cause pancreatitis. Case report: We report the case of a 20-year-old man who presented with abdominal pain and an epigastric mass. A diagnosis of a pancreatic hydatid cyst was established by ultrasonography and CT scan before surgery. The treatment consisted of laparoscopic cyst evacuation with omentoplasty. The recovery was uneventful and the patient has remained symptom free so far. Conclusions: Hydatid disease should be considered in the differential diagnosis of all cystic masses in the pancreas, especially in the geographical regions where the disease is endemic. © 2011 Surgical Associates Ltd. Elsevier Ltd. All rights reserved.


Chauhan U.,MGM Hospital | Shanbag P.,MGM Hospital | Mallad V.,MGM Hospital
Indian Journal of Pediatrics | Year: 2013

Myoclonic jerks presenting with fever have only rarely been reported and have often been misdiagnosed as febrile seizures. The presentation may be dramatic enough to provoke unnecessary investigation and treatment. Considering the benign nature of this condition, it is important that the condition is recognized by the physician so that hospitalisation and diagnostic procedures such as lumbar puncture and electroencephalogram are prevented. The authors report three cases of febrile myoclonus and review the subject. © 2013 Dr. K C Chaudhuri Foundation.

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