Omhare A.,GSVM Medical College |
Singh S.K.,Mlb Medical College |
Nigam J.S.,Saraswathi Institute of Medical science |
Sharma A.,Ddu Hospital
Pathology Research International | Year: 2014
Background. FNAC is a useful method for evaluating suspicious salivary glands lesions due to its low cost, minimum morbidity, rapid turnaround time, high specificity, and sensitivity. Aim. To knowthe frequency of the salivary gland lesions and cytohistological correlation in the Jhansi region, Uttar Pradesh, India. Material and Methods. In present study 124 cases were included and cytohistological correlation was made in 86 cases only. FNA was performed by using a 23/24-gauge needle without local anaesthesia. Air dried and 95% ethyl alcohol fixed wet smears were stained with Giemsa stain and Papanicolaou stain, respectively. Paraffin embedded tissue sections were stained with Haematoxylin and Eosin. Results. Parotid gland was the most commonly involved salivary gland. The commonest age group was 20 to 29 years, 30 to 39 years, and 60 to 69 years for nonneoplastic lesions, benign tumours, and malignant tumours, respectively.The overall male to female ratio was 1.17 : 1.The diagnostic accuracy of FNAC was 100%, 93.3%, and 88.2% for nonneoplastic lesions, benign tumours, and malignant tumours, respectively. Conclusion. The high accuracy, sensitivity, and specificity of FNAC confirmthat preoperative cytology is a useful, quick, reliable diagnostic technique for rapid diagnosis and suitable for developing countries. Copyright © 2014 Anita Omhare et al.
Singh K.,Child Nutrition and Development Programme |
Badgaiyan N.,Child Nutrition and Development Programme |
Ranjan A.,Child Nutrition and Development Programme |
Dixit H.O.,National Rural Health Mission |
And 3 more authors.
Indian Pediatrics | Year: 2014
Objective: To assess the effectiveness of facility-based care for children with severe acute malnutrition (SAM) in Nutrition Rehabilitation Centers (NRC). Design: Review of data. Setting: 12 NRCs in Uttar Pradesh, India. Participants: Children admitted to NRCs (Jan 1, 2010 - Dec 31, 2011). Intervention: Detection and treatment of SAM with locally-adapted protocols. Outcomes: Survival, default, discharge, and recovery rates. Results: 54.6% of the total 1,229 children admitted were boys, 81.6% were in the age group 6-23 months old, 86% belonged to scheduled tribes, scheduled castes, or other backward castes, and 42% had edema or medical complications. Of the 1,181 program exits, 14 (1.2%) children died, 657 (47.2%) children defaulted, and 610 (51.7%) children were discharged The average (SD) weight gain was 12.1 (7.3) g/kg body weight/day and the average (SD) length of stay was 13.2 (5.6) days. 206 (46.8%) children were discharged after recovery (weight gain ≥15%) while 324 (53.2%) were discharged, non-recovered (weight gain <15%) Conclusions: NRCs provide life-saving care for children with SAM; however, the protocols and therapeutic foods currently used need to be improved to ensure the full recovery of all children admitted. © 2014 Indian Academy of Pediatrics.
Rao T.S.S.,JSS University |
Tandon A.,MLB Medical College
Current Opinion in Psychiatry | Year: 2014
PURPOSE OF REVIEW: Sexual medicine is a branch often neglected by professionals from different specialties associated with it. However, research in this field has picked up in recent years, owing to recently renewed interest in upholding the sexual rights of the population in general and lesbian, gay, bisexual and transgender groups in particular. The recently released Diagnostic and statistical manual of mental disorders, fifth edition, by the American Psychiatric Association in May 2013 has stirred up the supporters and critics (of Diagnostic and statistical manual of mental disorders, fifth edition) alike. RECENT FINDINGS: Diagnostic and statistical manual of mental disorders, fifth edition, has updated diagnostic criteria for some of the sexual disorders to improve understanding and diagnostic validity. Certain sexual dysfunctions have been regrouped and sexual response cycle-based classification has been partially withdrawn. Research in the area of behavioral management of sexual dysfunctions has given some novel concepts, particularly for women. SUMMARY: Although improvements in behavioral management (of sexual dysfunctions) and classification/diagnostic criteria in Diagnostic and statistical manual of mental disorders, fifth edition, is a step forward in the field of sexual medicine, we need to further improve our understanding in many of the lacunae, still bearing on the field of sexual medicine, lest we may fall at the first hurdle. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Gupta D.K.,MLB Medical College |
Kumar G.,Jhansi Orthopaedic Hospital and Research Center
Indian Journal of Orthopaedics | Year: 2010
Background: The management of an atrophic nonunion with a gap following a fracture of the radius and/or ulna is a challenging problem. Various methods of treatment available in the literature are cortical tibial graft (Boyd), ulnar segment graft (Miller and Phalen), iliac crest graft (Spira), cancellous insert graft (Nicoll), vascularized fibular graft (Jupiter), and bone transport by ring fixator (Tesworth). The present study reports the results of tricorticocancellous bone block grafts using modified Nicolls technique, in diaphyseal defects of forearm bones. Materials and Methods: A total of 38 forearm bones (either radius or ulna or both) in 23 patients with a gap of 1.5-7.5 cm were treated by debridement and tricorticocancellous bone block graft under compression with intramedullary nail fixation between June 1985 and June 2005. There were 15 male and 8 female patients. Sixteen patients had open and seven patients had closed fractures initially. Time of presentation since the original injury varied from 9 months to 84 months. Eighteen patients had already undergone one to three operations. Results: Thirty-six bones showed union at both host graft junctions. The mean duration of union was 17.5 weeks (range, 14-60 weeks). Two bones had union only at one host graft junction and did not show any evidence of callus formation up to 9 months on the other end, hence requiring subsequent procedure in the form of phemister bone grafting. Patients were followed for a minimum period of 2 years (range, 2-7 years). Results were based on the status of union and range of motion (ROM) for elbow/wrist and grip strength at the final follow-up. Complications observed were the reactivation of infection (n = 1) and herniation of the muscles at the donor site (n = 1). Conclusion: The tricorticocancellous strut bone grafting under optimal compression, augmented with intramedullary fixation, provides a promising solution to difficult problem of an atrophic nonunion of forearms bones with gap.
Sahu K.K.,MLB Medical College |
Manar M.K.,University of Lucknow |
Singh S.K.,University of Lucknow |
Singh H.,S N Medical College
Journal of Global Infectious Diseases | Year: 2015
Aims: The objective of the study was to assess epidemiological and anti-rabies vaccination status in animal bite patients attending the Infectious Diseases Hospital, Lucknow. Materials and Methods: A longitudinal survey was conducted in the Infectious Diseases Hospital of Lucknow from January to December 2013. During this duration a total of 390 patients presenting with animal bites were included. Results: A majority (63.3%) of patients were in the 16-59 years age group. 75% of patients had attended the IDH for rabies post-exposure prophylaxis (PEP) within 24 hours. The male to female ratio was 2.98:1. A majority (79.5%) of patients were injured by dogs. 9.0% patients were in close contact with rabies patient. On the basis of WHO classification, 4.2% of animal bite patients were placed in grade I, 88.2 in grade II and 7.6% in grade III. In 73.3% of patients wound were in lower limbs. Complete vaccination was found in 65.0% and the use of human rabies immune globulin was only in 11.1%. Conclusion: Outcome of an animal bite can be fatal. The only preventive/curative measure available is anti-rabies vaccination and the use of human rabies immune globulin, hence to assure 100% compliance for the same awareness campaign is required.
Sinha R.,MLB Medical College
Journal of Laparoendoscopic and Advanced Surgical Techniques | Year: 2011
Introduction: Notes is the logical answer to scarless surgery, but despite being around for almost 4-5 years, it has to still garner a major support because of a number of limitations. Single-incision laparoscopic surgery, especially when done through the umbilicus, should be the perfect answer as far as the absence of any visible scar is concerned. Materials and Methods: All the 67 patients were operated by the same surgeon through a transversely placed umbilical incision in the lower half of the umbilicus. Three conventional ports, 10, 5, and 5mm, were introduced through the same skin incision but separate transfacial punctures. The instruments included 10-mm and 5-mm 30° rigid telescopes and rigid instruments as in standard laparoscopic cholecystectomy. Patients with irreducible hernia and obstructed hernia were included, and those with strangulated hernia were excluded. Results: All the patients were men, with an average age of 38.6 years. Three patients had bilateral hernia and 2 each had irreducible and obstructed hernia. The mean operating time was 42.8 minutes for unilateral hernias when tackers were used and 51.7 minutes in those in whom intracorporeal suturing was done. The operating time for bilateral hernias was 71.7 minutes. There was minimal flap discharge, without infection, in 3 patients. There were no other complications. There were no conversions and no recurrences upto 9 months of follow-up. Conclusions: Transumbilical single-skin-incision laparoscopic transabdominal preperitoneal repair for groin hernias, performed solely with conventional instruments, is feasible, easy to learn, and probably the future of laparoscopic inguinal hernia repair. © Copyright 2011, Mary Ann Liebert, Inc.
Chaurasiya O.S.,Mlb Medical College |
Kumar L.,Mlb Medical College |
Sethi R.S.,Mlb Medical College
Indian Journal of Clinical Biochemistry | Year: 2013
Hyperlipidemia is increasing prevalent risk factor in children, concomitant with worldwide epidemic of obesity. Lipid disorder can occur either as primary event or secondary to an underlying disease. The primary dyslipidemia are associated with overproductions/or impaired removal of lipoprotein. The latter defect can be induced by an abnormality in either the lipoprotein itself or in the lipoprotein receptor. A 2 month old male baby was found to have highly viscous and milky serum. S. Cholesterol was 2,200 mg/dl and triglycerides 13,292 mg%. There was no dysmorphic feature. Child was anemic and had hepatosplenomegaly and xanthomas. There was positive history of hyperlipidemia in first maternal cousin. Parents of index case had normal lipid profile. The child was put on lipid lowering agents, Iron drops, medium chain fatty acid. © 2012 Association of Clinical Biochemists of India.
Sinha R.,MLB Medical College
Journal of Laparoendoscopic and Advanced Surgical Techniques | Year: 2013
Background: Apart from the required expertise, a major deterrent to laparoscopic common bile duct (CBD) lithotomy (LCDL) remains the relatively prohibitive cost of the flexible choledochoscope, and it also has a shortcoming of not being effective in removal of large impacted CBD stones. Subjects and Methods: All patients presenting with CBD stones were treated, without exclusion, by laparoscopic cholecystectomy plus transdochal LCDL after relevant investigations. LCDL was performed using a rigid nephroscope. The CBD was closed either with running 3-0 polyglactin acid (Vicryl™; Ethicon) sutures without a stent or around a T tube in a few patients. Perioperative parameters were recorded in all patients. Results: Transdochal LCDL was performed on 172 consecutive patients. Five patients had a prior open cholecystectomy, 26 patients presented with acute cholecystitis, 5 patients presented with mild acute pancreatitis, and 12 patients presented after failed endoscopic retrograde cholangiopancreatography. Twenty-eight (16.28%) patients had multiple stones, 2 had biliary sludge, and no stone was found in 3 patients. Stone size varied from 4 to 12 mm. The average operative time was 68 minutes (range, 45-127 minutes). Primary repair was performed with 3-0 Vicryl continuous sutures, and the T tube was left in place in 13 (7.56%) patients. Conversion to an open procedure was required in 8 patients (4.65%). Postoperatively, mild acute pancreatitis occurred in 1 patient, and biliary peritonitis occurred in 5 patients. Conclusions: Rigid scope transdochal LCDL is feasible, probably easier, better for impacted large CBD stones, and definitely more affordable. © Copyright 2013, Mary Ann Liebert, Inc. 2013.
Sinha R.,Mlb Medical College |
Chandra S.,Mlb Medical College
Journal of Laparoendoscopic and Advanced Surgical Techniques | Year: 2012
Background: Leakage from the clipped cystic duct stump (cystic duct stump leak [CDSL]) as a cause of biliary peritonitis has not been emphasized enough. It deserves special mention because it is not an uncommon cause and it is easier to treat. With the advent of laparoendoscopic single-site (LESS) cholecystectomy, its occurrence in relation to other causes of biliary peritonitis needs reexamination. Subjects and Methods: Details of 756 patients undergoing LESS cholecystectomy were analyzed, and patients presenting with biliary peritonitis were identified. The investigative profile included an ultrasound, contrast-enhanced computed tomography scan, and endoscopic retrograde cholangiopancreatography (ERCP) to identify the site of leak. The management in addition to stenting included abdominal tube drainage. Results: There were 5 (0.66%) patients, all female, with biliary peritonitis, and 4 of them (0.53%) had cystic stump leakage as identified by ERCP. The usual time of presentation was in the first week after surgery, with acute abdominal pain and vomiting. Common bile duct stenting was carried out, after choledocholithotomy where required, at the same ERCP session. Tube abdominal drain was required in 2 patients, and 1 patient had to undergo exploratory laparotomy for an associated acute intestinal obstruction. All the patients recovered completely. The stent was removed between 4 and 6 weeks after ERCP. Conclusions: Effective CDSL management requires early recognition and management. ERCP is the cornerstone for correct identification, and common bile duct stenting was curative in all patients. © Copyright 2012, Mary Ann Liebert, Inc. 2012.
Sinha R.,MLB Medical College
Journal of Laparoendoscopic and Advanced Surgical Techniques | Year: 2011
Background: The quest for scarless surgery continues, but the goal remains elusive. The logical top contender was natural orifice surgery, but unfortunately even today it remains in infancy. Minilaparoscopy also did not generate much interest. In this scenario, transumbilical single-incision laparoscopy surgery holds promise, especially as far as cosmetics is concerned, and may be the ultimate answer. Methods: All the 240 patients were operated by the same surgeon through a transversely placed umbilical incision in the upper half of the umbilicus. Three conventional ports, 10, 5, and 5 mm, were introduced through the same skin incision but separate transfacial punctures. The instruments included 10- and 5-mm 30° rigid telescopes and rigid instruments as in standard laparoscopic cholecystectomy (SLC). Patients with acute cholecystitis and calculous pancreatitis were included, but those with choledocholithiasis were excluded. Results were compared with those with SLC. Results: Patients were predominately female, with an average age of 37.6 years. Ten patients had difficult gallbladders, 24 had acute cholecystitis, and 10 had calculous pancreatitis. The mean operating time was 25.8 minutes, compared with 18.4 minutes in SLC. Intracorporeal knotting was required in 2 patients. Conversion to SLC was required in 5 patients. Morrisons pouch drain was left in 1 patient. Injectable analgesic was required in 138 (57.5%) patients and infection was seen in 2 (0.8%) patients. Conclusions: Transumbilical single-skin-incision laparoscopic cholecystectomy performed solely with conventional instruments is feasible, easy to learn, and probably the future of laparoscopic cholecystectomy. © 2011, Mary Ann Liebert, Inc.