MM Institute of Medical science and Research

Ambāla, India

MM Institute of Medical science and Research

Ambāla, India
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Malhotra S.K.,MM Institute of Medical science and Research
Anaesthesia, Pain and Intensive Care | Year: 2016

The various studies conducted till date reveal that up to 40% patients undergoing coronary artery bypass surgery are associated with minor or persistent neuropsychological disorders. A significant concern has been emphasized on short and long term morbidity in cases of CABG procedure. The outcome in the form of morbidity after this surgery, irrespective of co-existing medical diseases, is prevalent in presence of neuropsychological problems, such as anxiety, depression and cognitive impairments, though the exact mechanism of this behavioural aspect is obscure. As such, there may not be serious psychological dysfunction but chances of incident delirium at the time of admission are quite high. These neuropsychological deficits may continue over time, especially if the features persisted in preoperative period, too. To improve the detection of these psychological disorders in CABG surgery cases, the clinicians must consider the use of specified screening methods. Perioperative factors, as well as patient- related risk factors, play a vital role in development of cognitive dysfunctions. Recent literature emphasizes the possibility of a grave complication in the form of ischaemic stroke in post- CABG surgical patients. The microemboli may enter cerebral circulation during surgery leading to cognitive decline, postoperatively. In the recent literature, that include various studies covering the neuropsychological areas, conflicts and limitations in methodology are prevalent.

Chaudhry M.,MM Institute of Medical science and Research
Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH | Year: 2012

We report a case of an epithelial inclusion cyst of the iris following cataract surgery that was successfully treated with en bloc excision, after an unsuccessful attempt with Neodymium-doped Yttrium Aluminium Garnet (Nd YAG) Laser. A 60-year-old man had undergone cataract surgery two years back. One year later, he developed a pigmented epithelial inclusion cyst of the iris which progressively increased in size. His vision reduced to finger counting close to face as the cyst grew over the pupil. We performed Nd YAG laser cystotomy of the cyst wall initially, but the treated lesion recurred. So we performed an en bloc iris excision of the cyst with sector iridectomy. There was no recurrence as determined by slit lamp examination at six months after treatment. Hence, we conclude that en bloc excision can be used to effectively treat epithelial inclusion cyst of the iris. © NEPjOPH.

Garg P.,Fortis Super Specialty Hospital | Garg P.,MM Institute of Medical science and Research | Garg M.,Indus Super Speciality Hospital | Menon G.R.,Indian Council of Medical Research ICMR
Colorectal Disease | Year: 2013

Aim: A systematic review was carried out to analyse continence at 2 years or more after lateral internal sphincterotomy (LIS) for chronic anal fissure (CAF). Method: PubMed, MEDLINE, Scopus, Embase, Ovid, SCI, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar were used to search the literature from 1969-2012 for studies reporting a follow-up of more than 2 years after LIS for CAF. The primary outcome parameter analysed was continence. The secondary outcome parameters included success rate, recurrence, incidence of postoperative abscess and fistula formation and patient satisfaction. Results: Of 324 studies screened, 22 (n = 4512) were included. The mean follow-up period ranged from 24-124 months. The overall continence disturbance rate was 14% (95% CI 0.09-0.2). Weighted analysis showed flatus incontinence in 9% (95% CI 0.04-0.16), soilage/seepage in 6% (95% CI 0.03-0.1), accidental defaecation in 0.91% (95% CI 0.003-0.02), incontinence to liquid stool in 0.67% (95% CI 0.001-0.02) and incontinence to solid stool in 0.83% (95% CI 0.003-0.02) of patients. Conclusion: The long-term risk of continence disturbance after lateral internal sphincterotomy is significant. Randomized controlled trials with a long follow-up are needed to substantiate these findings and to redefine its role in the treatment of chronic anal fissure. © 2013 The Association of Coloproctology of Great Britain and Ireland.

Gupta S.,MM Institute of Medical science and Research
Journal of medicine and life | Year: 2013

Herpes Zoster (HZ) is a Cutaneous Viral infection caused by Varicella zoster virus (VZV). Lesions of HZ are usually limited to one dermatome only but sometimes, there can be dissemination of lesions. The present case describes the role of proper examination of HZ case, which presents with disseminated lesions.

Bagga P.K.,MM Institute of Medical science and Research | Mahajan N.C.,MM Institute of Medical science and Research
Indian Journal of Cancer | Year: 2010

Background: Fine needle aspiration cytology (FNAC) is widely considered as the diagnostic technique of choice in the assessment of thyroid lesions. Aims: The aim of this study is to determine the utility and diagnostic accuracy of FNAC of thyroid lesions performed at our institution and to compare our experience with that of the experts from other regions of the world. Setting and Design: The present study is a five-year retrospective study of FNAC of thyroid lesions performed in the Pathology Department of our institute, during the period January 2004 to December 2008. The FNAC findings were correlated with the histopathological diagnosis, wherever available. Materials And Methods: 0 The records of 252 patients who had undergone FNAC during the study period were retrieved and information about age, sex, FNAC, and Histopathological diagnoses were extracted and the corresponding original slides were reviewed. The cytological results were classified as inadequate, benign, suspicious, and malignant. The histopathology diagnosis was classified as non-neoplastic (benign) and neoplastic (malignant). Results: A total of 252 FNACs of thyroid lesions were done during the study period. The results of the FNA cytological diagnosis showed that four (1.6%) of the patients had FNAs, which were inadequate for cytological assessment, 228 (90.5%) patients had benign lesions, 17 (6.7%) had lesions that were suspicious for malignancy, and three (1.2%) had malignant neoplasms. The correlation of the FNAC findings with the histopathological diagnosis, showed that our FNAC diagnostic accuracy rate was 96.2%, with a sensitivity of 66%, and specificity of 100%. Conclusions: The results of our study are comparable with the current published data and demonstrate that FNA cytology is a sensitive, specific and accurate initial diagnostic test for the preoperative evaluation of patients with thyroid swellings in our setting as well. The clinicians should be encouraged to embrace this procedure in the initial management of such patients.

Singh R.,MM Institute of Medical science and Research
Annals of African Medicine | Year: 2014

Occurrence of solitary intramuscular cysticercosis without involvement of the central nervous system is rare. We report a case of solitary cysticercosis of the brachioradialis muscle in a 35-year-old woman who presented with discomfort and pain in the right elbow and arm after trivial trauma. There were no systemic or neurological features.

Garg P.,MM Institute of Medical science and Research | Garg P.,Fortis Super Specialty Hospital | Thakur J.D.,Louisiana State University Health Sciences Center | Garg M.,MM Institute of Medical science and Research | Menon G.R.,Indian Council of Medical Research ICMR
Journal of Gastrointestinal Surgery | Year: 2012

Introduction: We analyzed different morbidity parameters between single-incision laparoscopic cholecystectomy (SILC) and conventional laparoscopic cholecystectomy (CLC). Methods: Pubmed, Ovid, Embase, SCI database, Cochrane, and Google Scholar were searched. The primary endpoints analyzed were cosmetic result and the postoperative pain (at 6 and 24 h) and the secondary endpoints were operating time, hospital stay, incidence of overall postoperative complications, wound-related complications, and port-site hernia. Results: Six hundred fifty-nine patients (SILC-349, CLC-310) were analyzed from nine randomized controlled trials. The objective postoperative pain scores at 6 and 24 h and the hospital stay were similar in both groups. The total postoperative complications, wound-related problems, and port-site hernia formation, though higher in SILC, were also comparable in both groups. SILC had significantly favorable cosmetic scoring compared to CLC [weighted mean difference = 1.0, p = 0.0001]. The operating time was significantly longer in SILC [weighted mean difference = 15.63, p = 0.0001]. Conclusions: Single-incision laparoscopic cholecystectomy does not confer any benefit in postoperative pain (6 and 24 h) and hospital stay as compared to conventional laparoscopic cholecystectomy while having significantly better cosmetic results at the same time. Postoperative complications, though higher in SILC, were statistically similar in both the groups. © 2012 The Society for Surgery of the Alimentary Tract.

Garg P.,Mm Institute Of Medical Science And Research
Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH | Year: 2012

The loss of an eye has a crippling effect on the psychology of the patient, making rehabilitation process challenging for both doctor and patient. To report a case of anophthalmic socket with prosthetic rehabilitation in a cost effective manner. A 32-year-old female presented with anophthalmic socket for prosthetic rehabilitation. A custom made ocular prosthesis was implanted successfully. The custom made ocular prosthesis is simple, affordable and can be carried out in a small clinical set-up and provides a superior natural appearance. © NEPjOPH.

Agrawal A.,MM Institute of Medical science and Research | Garg L.N.,MM Institute of Medical science and Research
Journal of Surgical Technique and Case Report | Year: 2011

Cranioplasty is a common, but formidable surgical procedure for neurosurgeons, in patients with scalp and / or calvarial defects. This procedure can be simple or complex. The main objectives of cranioplasty are: To achieve primary wound healing, obliterate dead space, and seal off sterile cranial areas from contaminated oronasal cavities, to restore the normal barriers protecting the intracranial structures (together with a satisfactory cosmetic result) and obtain a permanent or very durable reconstruction, using biologically inert materials, and also to restore the aesthetics. The greatest problem is selecting the optimum material for repair of the cranial defect. Many synthetic substitutions of the dura and bone are often used for reconstruction of the skull base; unfortunately, these methods bear significant disadvantages and can induce chronic inflammation, carry a high risk of infection, and are inferior to biological sources in terms of strength and sealing quality [with the exception of some materials, such as titanium mashes and CortossTM (Orthovita® , Malvern, USA), which are seen to have more strength than the thin split thickness calvarial bone]. The primary aim of this article is to review the basic principles to use the split calvarial graft for the reconstruction of the skull defect.

Chaudhry M.,MM Institute of Medical science and Research
Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH | Year: 2011

Posterior capsular opacification, also known as after cataract develops in 33 % of patients after uneventful cataract surgery. Nd-YAG Laser capsulotomy is the treatment of choice for PCO and is routinely performed by the general ophthalmologist on an OPD basis. Endophthalmitis, although a rare complication after Nd-YAG Laser capsulotomy, has been reported in the literature. We report a case of Propionibacterium acnes endophthalmitis following laser capsulotomy and the possible mechanism of its occurrence. © NEPjOPH.

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