MGM Medical College and Hospital
MGM Medical College and Hospital
Ganguly B.B.,MGM New Bombay Hospital |
Kadam N.N.,MGM Medical College and Hospital |
Mandal P.K.,Nil Ratan Sircar Medical College and Hospital
Journal of Cancer Research and Therapeutics | Year: 2017
Reports on imbalanced HSA21 gene expression and chromosomal rearrangements on leukemogenesis, drug sensitivity, and treatment outcome of leukemia in Down syndrome (DS) are limited. DS has been recognized as one of the most common leukemia-predisposing syndromes with unique clinical features, significant differences in treatment outcome and treatment-related toxicity profiles. Acute myeloid leukemia (AML), especially acute megakaryocytic leukemia, is reported with high cure rates presenting 80%-100% event-free survivals (EFSs); however, acute lymphoid leukemia indicates a worse prognosis in DS patients compared to non-DS children. Complex rearrangements are responsible for poor-to-very poor prognosis in all cases, irrespective of genetic predisposition or type of hematopoietic subunits affected. We report a 2-year-old female DS diagnosed with acute erythroleukemia (French-American-British: AML-M6) with highly complex chromosomal rearrangements in the bone marrow with 39 chromosomes. Parental consanguinity and genetic predisposition might be responsible for origin of multiple clones. Genetic instability and heterogeneity of complex clonal developments might cause poor prognosis. The case is a rare one with acute erythroleukemia in DS patient where too many rearrangements had masked identification of three 21s. © 2017 Indian Journal of Ophthalmology | Published by Wolters Kluwer - Medknow.
Sharma R.,MGM Medical College and Hospital |
Pai C.,MGM Medical College and Hospital
International Journal of Pharmaceutical Sciences Review and Research | Year: 2013
Enterococci are one of the leading causes of nosocomial infections with E. faecalis and E. faecium accounting up to 90% of the clinical isolates. However, the incidence of other species of enterococci from clinical sources shows an alarming increase with the properties of intrinsic resistance to several antibiotics including beta lactams and glycopeptides. Thus proper identification of enterococci to species level is quintessential for management and prevention of these bacteria in any healthcare facility. The incidence of enterococcal infections and species prevalent in India is not thoroughly investigated. The present study was carried out to determine the species distribution and antimicrobial susceptibilities of enterococci isolated from clinical samples in a tertiary care hospital of Western India. Specimens were cultured on blood agar. Enterococci were presumptively identified using bile esculin agar, L-pyrrolidonyl-b-napthylamide test (PYR), growth in 6.5% NaCl, growth at 10°C and 45°C. They were further identified to the species level by conventional biochemical tests. Kirby Bauer disc diffusion method was used to study the antibiogram of the enterococcal isolates. Out of 138 Enterococcus species recovered during the study period, E. faecalis (50%) and E. faecium (30%) constituted the predominant isolates. E. faecalis predominated urine and other exudates while in blood, E.faecalis and E.faecium were isolated in equal numbers. Other species isolated were E. durans, E. avium, E. raffinosus, E. casseliflavus and E. gallinarum. High-level Gentamycin resistance was detected in 71% of isolates. Resistance to vancomycin, teicoplanin and linezolid was shown by 26%, 18% and 13% of the isolates respectively. Prevalence of a wide variety of Enterococcus species in clinical samples together with their variable antimicrobial susceptibility patterns emphasizes the need for routinely carrying out detailed speciation and in vitro susceptibility testing of enterococcal isolates in the clinical bacteriology laboratory.
Shaikh T.,MGM Medical College and Hospital |
Dubhashi S.P.,MGM Medical College and Hospital
Journal of Krishna Institute of Medical Sciences University | Year: 2017
Calcinosis Cutis is characterized by the deposition of calcium salts in the skin and subcutaneous tissue. Idiopathic Calcinosis Cutis is a rare condition and hence is usually a diagnosis of exclusion. Idiopathic Calcinosis Cutis occurs in the absence of known trauma, inciting agent or metabolic defect. This is a case report of an adult female presenting with Idiopathic Calcinosis Cutis over the back. The exact mechanism of occurrence of this condition is not known. Patients are usually managed with pharmacotherapy, surgery being reserved for those with pain, recurrent infection and impaired function. The lesions are known to recur and a periodic follow-up of these patients is essential. © Journal of Krishna Institute of Medical Sciences University.
Ajinkya S.A.,MGM Medical College and Hospital
Sleep and Hypnosis | Year: 2015
We report a case of a 37 year old Indian media professional suffering from panic disorder with phobia for drinking water and other liquids (aquaphobia) for the last 10 years. Despite anti-anxiety medications and counselling, symptoms prevailed and affected his social and professional life. He was thus referred for hypnotherapy. The patient underwent six sessions of cognitive hypnotherapy. After successful completion of sessions he regularly started drinking water and other liquids without any further episodes of panic. There was also a remarkable improvement in his social and professional life. His anti-anxiety medications were then slowly tapered and stopped. There were no relapses reported by the patient even after six months of follow up. This case study deepens the confidence and evidence for using cognitive hypnotherapy in the management of neurotic disorders.
Setia M.S.,McGill University |
Shinde S.S.,Cutis Skin Clinic and Laser Center |
Jerajani H.R.,Mgm Medical College And Hospital |
Boivin J.-F.,Jewish General Hospital
Tropical Medicine and International Health | Year: 2011
Background A combination of rifampicin, ofloxacin and minocycline (ROM) is one of the newer recommendations for treatment of leprosy. We performed a systematic review and a meta-analysis of studies that had evaluated the efficacy of ROM therapy in treatment of paucibacillary and multibacillary leprosy patients. Methods Studies were identified by searching the PubMed, Embase, LILACS and Cochrane databases. Data were abstracted from all relevant studies, and fixed effects models were used to calculate the summary estimate of effect in paucibacillary and multibacillary leprosy patients. Results Six studies comparing ROM therapy to multidrug therapy and eight studies that evaluated the effect of ROM therapy alone (no comparison group) were included in the review and meta-analysis. The combined estimate for single dose ROM vs. multidrug therapy in paucibacillary leprosy patients suggested that ROM was less effective than multidrug therapy in these patients [relative risk: 0.91, 95% confidence intervals (CI): 0.86-0.97]. However, the combined estimate for multiple doses of ROM vs. multidrug therapy in multibacillary leprosy patients suggested that ROM was as effective as multidrug therapy in reducing bacillary indices in these patients (proportion change: -4%, 95% CI -31% to 23%). No major side effects were reported in either the ROM or the multidrug treatment groups. Conclusions Single-dose ROM therapy was less effective than multidrug therapy in paucibacillary patients. However, there are insufficient data to come to a valid conclusion on the efficacy of multidose ROM therapy in multibacillary leprosy, and additional studies with ROM therapy in multibacillary leprosy are needed. Furthermore, multiple doses may be considered as another alternative even for paucibacillary patients, and randomised controlled trials of this therapy may be useful to understand its contribution in the treatment and control of leprosy. © 2011 Blackwell Publishing Ltd.
Singh O.,Bhopal Memorial Hospital |
Gupta S.S.,Bhopal Memorial Hospital |
Hastir A.,MGM Medical College and Hospital |
Arvind N.K.,Bhopal Memorial Hospital |
Arvind N.K.,BGS Apollo Hospital
Journal of Endourology | Year: 2010
Background and Purpose: Laparoscopic dismembered pyeloplasty (LDP) is a minimally invasive approach that is becoming standard management of ureteropelvic junction obstruction (UPJO). It provides similar results when compared with open surgery. The main goal of LDP is to meet the standard of open dismembered pyeloplasty with reduced trauma for the patients. The purpose of the study was to evaluate the postoperative and functional results of LDP. Patients and Methods: We retrospectively reviewed and analyzed 142 cases of LDP performed at our center over a period of 7 years (January 2003 to December 2009) for UPJO with dilatation of the renal pelvis. Patients' profiles and perioperative, intraoperative, and postoperative parameters, such as time of surgery, blood loss, complications, duration of hospital stay, and outcomes of the procedure, were all evaluated and analyzed. Results: The mean operative time for LDP was 145 minutes (range 110-180 min), and the mean estimated blood loss was negligible in all patients. The mean hospital stay was 3.5 days (3-6 d). Two conversions to open surgery occurred because of difficulty to complete the anastomosis. In one patient, shock caused by bleeding from inferior epigastric vessels near the port site developed and had to be explored. The success rate was 96.8%. Conclusion: When performed by expert surgeons, LDP can safely achieve success rates that are comparable to those of open surgery described in the literature, with fewer complications and less morbidity to the patients. The few important difficulties with their management that we encountered are discussed. © 2010, Mary Ann Liebert, Inc.
Talib S.H.,MGM Medical College and Hospital |
Bhattu S.R.,MGM Medical College and Hospital |
Bhattu R.,MGM Medical College and Hospital |
Deshpande S.G.,MGM Medical College and Hospital |
Dahiphale D.B.,MGM Medical College and Hospital
International Medical Case Reports Journal | Year: 2013
We report a rare case of dengue fever triggering systemic lupus erythematosus and lupus nephritis. The patient presented herself during a large outbreak of dengue fever in December 2012 in Maharashtra, India. The diagnosis of dengue fever was confirmed by the presence of NS-1 antigen during the first few days of febrile illness. Eight weeks later, kidney tissue biopsy studies revealed evidence of lupus nephritis on microscopic examination and immunofluorescence. The report interpreted it as focal proliferative glomerulonephritis and segmental sclerosis (Stage IIIC). The case was also found positive for perinuclear antineutrophil cytoplasmic antibodies by indirect immunofluorescence assay. An active and effective management of a case essentially calls for clear perception of differentiating dengue-induced lupus flare, antineutrophil cytoplasmic antibody-related nephropathy, and/or dengue-induced de-novo lupus disease. Dengue viremia may be the trigger for immune complex formation in patients who are predisposed to developing autoimmune diseases. The present case explains the importance of considering the diagnosis of dengue-related lupus nephritis as an atypical occurrence in appropriate situations, as in this case. It would not be improper to regard this escalating disease as an expanded feature of dengue. © 2013 Talib et al.
Gupta S.S.,MGM Medical College and MY Hospital |
Singh O.,MGM Medical College and MY Hospital |
Sabharwal G.,NKP Salve Medical College and Lata Mangeshkar Hospital |
Hastir A.,MGM Medical College and Hospital
ANZ Journal of Surgery | Year: 2011
Objectives: To compare the effectiveness of percutaneous catheter drainage (PCD) and percutaneous needle aspiration (PNA) in the management of large (>10cm diameter) amoebic liver abscesses. Methods: Eighty-two patients with amoebic liver abscess were randomly allocated to PCD (n= 42) or PNA (n= 40). Intervention was done under ultrasonography (US) [mainly] or computed tomography guidance within 24h of admission. PNA was repeated every 3rd day if the cavity size had not reduced to 50% of the original size, for up to three times. Persistence of cavity or of clinical symptoms was considered failure of treatment. Duration to attain clinical relief, duration of hospital stay, complications, treatment failure and deaths were recorded. Results: PNA was successful in 32 (80%) patients (one aspiration in 4, two in 18 and three in 10 patients), while PCD was successful in 38 (90.5%) patients. Durations to attain clinical relief and parentral antibiotics required were significantly lesser in the PCD group. Hospital stay, although did not differ significantly, was lesser for PCD group. The only procedure-related complication due to PCD was rupture of abscess in two cases, leading to sepsis and death of one patient. Complications of PNA included pleural injury in one patient, and haemorrhage leading to subcapsular hematoma in another. Conclusion: PCD is a better treatment option than PNA for the management of large (>10cm diameter) amoebic liver abscess, in terms of duration to attain clinical relief and duration for which parentral antibiotics were needed. © 2010 The Authors. ANZ Journal of Surgery © 2010 Royal Australasian College of Surgeons.
Ansari I.,MGM Medical College and Hospital |
Futane S.,MGM Medical College and Hospital |
Ansari A.,MGM Medical College and Hospital
Acta Neurochirurgica | Year: 2016
Background: Sub-acute/chronic epidural hematoma (EDH) may present with nagging symptoms of headache, nausea, vomiting, lethargy, etc. We attempted to offer a minimally invasive, single burr hole, endoscope-assisted evacuation of EDHs instead of a conventional craniotomy. Methods: Seven patients with sub-acute/chronic EDH (six supratentorial and one infratentorial) presented to us 3 to 7 days after low-velocity road traffic accidents with complaints of headache and lethargy. The EDH volumes measured between 20 to 50 ml, and the patients were operated on using a single burr hole made through a small incision. We used 0-, 30- and 70-degree, angulated, rigid, high-definition endoscopes to identify and evacuate the organized clots in the extradural space. Flexible catheters were used for suction and irrigation. After achieving hemostasis, the dura was hitched back to the burr hole site. The wound was closed over a negative suction drain. Results: All patients had prompt recovery from symptoms. Postoperative CT scans showed complete or near complete evacuation of the hematomas. The hospital stay and analgesic requirements were minimal. There was no infective complication or conversion to conventional open surgery. The average time for surgery was 77.8 min, and average blood loss was 328.5 ml. Conclusion: Endoscope-assisted evacuation of sub-acute/chronic EDH is a novel concept, which offers quick relief from symptoms in a minimally invasive fashion and a cosmetically acceptable way. None of the standard principles of surgery are hampered. It avoids extensive dissection of the temporalis or sub-occipital muscles. However, achieving hemostasis can be difficult. Further study and better equipment will validate the procedure. © 2016, Springer-Verlag Wien.
Ganguly B.B.,MGM New Bombay Hospital |
Kadam N.N.,MGM Medical College and Hospital
Mutation Research - Reviews in Mutation Research | Year: 2016
The plethora of knowledge gained on myelodysplastic syndromes (MDS), a heterogeneous pre-malignant disorder of hematopoietic stem cells, through sequencing of several pathway genes has unveiled molecular pathogenesis and its progression to AML. Evolution of phenotypic classification and risk-stratification based on peripheral cytopenias and blast count has moved to five-tier risk-groups solely concerning chromosomal aberrations. Increased frequency of complex abnormalities, which is associated with genetic instability, defines the subgroup of worst prognosis in MDS. However, the independent effect of monosomal karyotype remains controversial. Recent discoveries on mutations in RNA-splicing machinery (SF3B1, SRSF2, ZRSR2, U2AF1, U2AF2); DNA methylation (TET2, DNMT3A, IDH1/2); chromatin modification (ASXL1, EZH2); transcription factor (TP53, RUNX1); signal transduction/kinases (FLT3, JAK2); RAS pathway (KRAS, NRAS, CBL, NF1, PTPN11); cohesin complex (STAG2, CTCF, SMC1A, RAD21); DNA repair (ATM, BRCC3, DLRE1C, FANCL); and other pathway genes have given insights into the independent effects and interaction of co-occurrence of mutations on disease-phenotype. RNA-splicing and DNA methylation mutations appeared to occur early and are reported as 'founder' mutations in over 50% MDS patients. TET2 mutation, through altered DNA methylation, has been found to have independent prognostic response to hypomethylating agents. Moreover, presence of DNMT3A, TET2 and ASXL1 mutations in normal elderly individuals forms the basis of understanding that accumulation of somatic mutations may not cause direct disease-development; however, cooperation with other mutations in the genes that are frequently mutated in myeloid and other hematopoietic cancers might result in clonal expansion through self-renewal and/or proliferation of hematopoietic stem cells. Identification of small molecules as inhibitors of epigenetic mutations has opened avenues for tailoring targeted drug development. The recommendations of a Clinical Advisory Committee is being considered by WHO for a revised classification of risk-groups of MDS, which is likely to be published in mid 2016, based on the new developments and discoveries of gene mutations. © 2016 Elsevier B.V.