Nair Hospital

Mumbai, India

Nair Hospital

Mumbai, India

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Shah J.R.,Spectrum | Patkar D.P.,Dr Balabhai Nanavati Hospital And Research Center | Kamat R.N.,Nair Hospital
Neuroradiology Journal | Year: 2013

Huntington's disease and neuroacanthocytosis may present similar clinical and MRI features. It is important to differentiate these findings since treatment and prognosis vary vastly between them. The aim of this article is to familiarize radiologists with the differentiating features of Huntington's disease and various diseases comprising neuroacanthocytosis. A 40-year-old Indian man with extrapyramidal symptoms was referred for MRI. The clinical diagnosis was Huntington's disease, but there were a few atypical clinical features such as a history of biting the tongue, tics, marked hyporeflexia and lower limb muscle wasting. MR showed atrophy of the caudate nucleus and putamen with iron deposition in the basal ganglia, which can be seen in Huntington's disease and in neuroacanthocytosis. An increased blood acanthocyte level was subsequently confirmed. Further work-up revealed increased serum creatine phosphokinase levels, normal serum lipoprotein levels and depressed K cell antigen activity on serological studies, confirming the diagnosis of McLeod syndrome. McLeod syndrome is one of the distinct phenotypes of neuroacanthocytosis. Neuroacanthocytosis is a group of disorders with increased serum acanthocyte counts and neurological involvement. Various causes of neuroacanthocytosis are discussed. It is important to consider the possibility of neuroacanthocytosis when features typical of Huntington's disease are encountered on imaging.


Shetty A.,Abshetty Memorial Institute Of Dental Science | Hegde M.N.,Abshetty Memorial Institute Of Dental Science | Tahiliani D.,Abshetty Memorial Institute Of Dental Science | Shetty H.,Nair Hospital | And 2 more authors.
Journal of Clinical and Diagnostic Research | Year: 2014

Background: Conventional radiographic techniques being two dimensional, has its restrictions and is confined to limited diagnostic value. However, the incorporation of Cone Beam Computed Tomography (CBCT) gives a three dimensional insight to the tooth morphology and leads to better evaluation and treatment management. Aim: The aim of this study was to evaluate and assess the root canal morphology of mandibular pre-molars in South Indian Population using CBCT radiographic technique. Materials and Methods: One thousand and eighty six and Eight hundred and fourteen fully erupted mandibular first and second premolars respectively were scanned using CBCT to evaluate the canal morphology according to Vertucci and Gulabiwala's classification. Results: The most common configuration in mandibular first and second premolars was Vertucci's Type I(83.81% and 93.48% respectively) followed by Type V (11.97% and 3.5% respectively). Conclusion: South Indian Population presented Type IV ertucci's canal morphology as the most common in mandibular first and second pre-molars followed by Type V. CBCT scanning poses a greater advantage in assessing the complexity of root canal morphology and planning an appropriate endodontic treatment for the same.


Sandur V.,Nair Hospital | Murugesh M.,Nair Hospital | Banait V.,Nair Hospital | Rathi P.,Nair Hospital | And 3 more authors.
Journal of Postgraduate Medicine | Year: 2014

Background: The hypothesis that GER can trigger or exacerbate asthma is supported by several clinical trials that have shown amelioration in asthma symptoms and/or an improvement in pulmonary function after antireflux therapy. Aims: To investigate the prevalence of GER in patients with difficult to control asthma and to determine the effect of omeprazole on asthma symptoms, reflux symptoms, pulmonary function and on the requirement of asthma medications. Materials and Methods: Patients with difficult to control asthma were recruited into the study. All patients underwent esophageal manometry and 24 hour esophageal pH monitoring. Pulmonary function tests were done before and after treatment. The severity of asthma and reflux was assessed by a 1 week pulmonary symptom score(PSS) and reflux symptom score(RSS) respectively before and after treatment. Those who had an abnormal pH study (pH <4 in the distal esophagus for >5% of the time) underwent anti-GER treatment with lifestyle changes, and a proton pump inhibitor (omeprazole 40 mg, bid) for 3 months. Asthma medications were added or deleted based on severity of asthma. Results: Out of 250 asthmatic patients screened, forty patients fulfilled the inclusion criteria. Twenty eight of 40 patients(70%) were diagnosed to have GERD. Of the patients 28 with GER, 8 patients(28.5%) had no reflux symptoms. On 24 hr pH metry, the percentage time pH <4.0 was 10.81 ± 4.72 and 1.11 ± 1.21; Deemester score was 37.65 ± 14.54 and 4.89 ± 6.39 (p-value is 0.0001) in GERD and non-GERD patients respectively.In GERD group, post treatment reflux symptom score(RSS) improved from 22.39 ± 14.99 to 1.04 ± 1.07, pulmonary symptom score(PSS) improved from27.14 ± 7.49 to 13.82 ± 4.21and night time asthma symptom score(NASS) improved from 6.71 ± 1.80 to 3.04 ± 1.23 (p-value <0.0001). After treatment, FEV1 and PEFR increased from 1.38 ± 0.57 and 4.14 ± 1.97 to 1.47 ± 0.54 and 5.56 ± 1.72, respectively (p-value 0.00114). Conclusions: PPI therapy improves nocturnal asthma symptoms, daytime asthma symptoms, pulmonary function and decreases requirement of asthma medications in these patients.


Baldwa M.,Nair Hospital | Baldwa N.,Nair Hospital | Padvi A.,KEM Hospital
Indian Journal of Practical Pediatrics | Year: 2013

Death, which has to be peaceful, has become painful and artificial one, away from the family surrounded by the paraphernalia of modern Intensive Care Unit (ICU). Legally, active euthanasia is a crime and passive euthanasia is considered as conditionally permitted. Prolonged and futile life support leads to economic strain. As per Supreme Court (SC) guidelines in Aruna Shanbaug case, institutions can draw protocols/guidelines, for not starting and stopping/withholding resuscitation. We suggest admitting all "End-Of-Life-Situation" (EOLS) patients in specially designated "EOLS-ICU" for increasing the efficiency of regular ICU. Advantage of this is that parents/relatives will allow pediatricians to administer passive euthanasia protocol ethically, legally and psychologically in EOLS-ICU, since other patients in EOLS-ICU, are also in similar situation.


Background: Acne scars occur consequent to abnormal wound healing following sebaceous follicular inflammation in acne. Various types of acne scars are icepick, rolling, boxcar, hypertrophic, and keloidal. Different modalities of treatment include subcision, dermaroller, cryoroller, punch excision, chemical peeling, and lasers. Objectives: To compare the efficacy of combined subcision and dermaroller vs. combined subcision and cryoroller in acne scar treatment. Methods: Thirty patients (19 males and 11 females) with grade 2, 3, and 4 postacne scarring (Goodman and Baron qualitative grading system) were enrolled in the study. Three sittings each at 1-month interval were carried out of subcision under nerve block on the entire face followed by derma roller (2.5 mm) and cryoroller on one half of the face. Standardized digital photography was performed preprocedure and at 6 months. Grading of acne scar photographs using the Goodman and Baron qualitative and quantitative grading scale was carried out by a blinded observer pre- and postprocedure at 6 months. Patients' own evaluation based on patient scar severity perception scale of 1-10 was also taken into account. Results: Assessment using the quantitative grading scale showed a 57% improvement using combined subcision and cryoroller against 40% improvement with combined subcision and dermaroller. Average improvement perceived by the subjects was 61% with combined subcision and cryoroller against 45% with combined subcision and dermaroller. The data were analyzed using Wilcoxon signed rank test and found statistically significant. Postinflammatory hyperpigmentation on the cryoroller side and erythema, edema, and hematoma formation due to subcision was transient. Conclusion: Combined subcision and cryoroller is more effective than combined subcision and dermaroller for treatment of acne scars. © 2014 Wiley Periodicals, Inc.


Andrade N.N.,Nair Hospital | Mhatre T.S.,Nair Hospital
Journal of Oral and Maxillofacial Surgery | Year: 2012

The aim of this study was to evaluate clinical signs and symptoms of orofacial tuberculosis, with an emphasis on the importance of histologic diagnosis. Based on an evaluation of 46 patients, Andrade's classification is presented with a novel 10-point protocol for the management of orofacial tuberculosis. Forty-six patients were evaluated for orofacial tuberculosis over 16 years (1996 through 2011). All 46 patients were managed with a 10-point protocol for the care of orofacial tuberculosis. Forty-six cases with a positive diagnosis of orofacial tuberculosis were confirmed by histopathologic and other investigations specified in the 10-point protocol for the management of orofacial tuberculosis. The male:female ratio was 0.917, with no gender predilection. Most cases were seen in the second and third decades of life. A large number of patients (n = 22) presented with a lesion in relation to the angle of the mandible. In a tuberculosis-prevalent country such as India, it is very important to be aware of tubercular lesions involving the orofacial region. Andrade's classification of orofacial tuberculosis helped classify different forms of tubercular lesions that may involve the orofacial region. The 10-point protocol formulated and applied to all 46 cases proved successful in the management of these cases. © 2012 American Association of Oral and Maxillofacial Surgeons.


PubMed | Nair Hospital and Abshetty Memorial Institute Of Dental Science
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2014

Conventional radiographic techniques being two dimensional, has its restrictions and is confined to limited diagnostic value. However, the incorporation of Cone Beam Computed Tomography (CBCT) gives a three dimensional insight to the tooth morphology and leads to better evaluation and treatment management.The aim of this study was to evaluate and assess the root canal morphology of mandibular pre-molars in South Indian Population using CBCT radiographic technique.One thousand and eighty six and 814 fully erupted mandibular first and second premolars respectively were scanned using CBCT to evaluate the canal morphology according to Vertucci and Gulabiwalas classification.The most common configuration in mandibular first and second premolars was Vertuccis Type I(83.81% and 93.48% respectively) followed by Type V (11.97% and 3.5% respectively).South Indian population presented Type IV ertuccis canal morphology as the most common in mandibular first and second pre-molars followed by Type V. CBCT scanning poses a greater advantage in assessing the complexity of root canal morphology and planning an appropriate endodontic treatment for the same.


PubMed | Medical Research Council Human Nutrition Research, Apnalaya, Nair Hospital, University of Southampton and 2 more.
Type: Journal Article | Journal: The British journal of nutrition | Year: 2015

Intakes of micronutrient-rich foods are low among Indian women of reproductive age. We investigated whether consumption of a food-based micronutrient-rich snack increased markers of blood micronutrient concentrations when compared with a control snack. Non-pregnant women (n 222) aged 14-35 years living in a Mumbai slum were randomised to receive a treatment snack (containing green leafy vegetables, dried fruit and whole milk powder), or a control snack containing foods of low micronutrient content such as wheat flour, potato and tapioca. The snacks were consumed under observation 6d per week for 12 weeks, compliance was recorded, and blood was collected at 0 and 12 weeks. Food-frequency data were collected at both time points. Compliance (defined as the proportion of women who consumed 3 snacks/week) was >85% in both groups. We assessed the effects of group allocation on 12-week nutrient concentrations using ANCOVA models with respective 0-week concentrations, BMI, compliance, standard of living, fruit and green leafy vegetable consumption and use of synthetic nutrients as covariates. The treatment snack significantly increased -carotene concentrations (treatment effect: 471nmol/l, 95% CI 65, 877). There was no effect of group allocation on concentrations of ferritin, retinol, ascorbate, folate or vitamin B12. The present study shows that locally sourced foods can be made into acceptable snacks that may increase serum -carotene concentrations among women of reproductive age. However, no increase in circulating concentrations of the other nutrients measured was observed.


The hypothesis that GER can trigger or exacerbate asthma is supported by several clinical trials that have shown amelioration in asthma symptoms and/or an improvement in pulmonary function after antireflux therapy.To investigate the prevalence of GER in patients with difficult to control asthma and to determine the effect of omeprazole on asthma symptoms, reflux symptoms, pulmonary function and on the requirement of asthma medications.Patients with difficult to control asthma were recruited into the study. All patients underwent esophageal manometry and 24 hour esophageal pH monitoring. Pulmonary function tests were done before and after treatment. The severity of asthma and reflux was assessed by a 1 week pulmonary symptom score(PSS) and reflux symptom score(RSS) respectively before and after treatment. Those who had an abnormal pH study (pH <4 in the distal esophagus for >5% of the time) underwent anti-GER treatment with lifestyle changes, and a proton pump inhibitor (omeprazole 40 mg, bid) for 3 months. Asthma medications were added or deleted based on severity of asthma.Out of 250 asthmatic patients screened, forty patients fulfilled the inclusion criteria. Twenty eight of 40 patients(70%) were diagnosed to have GERD. Of the patients 28 with GER, 8 patients(28.5%) had no reflux symptoms. On 24 hr pH metry, the percentage time pH <4.0 was 10.81 4.72 and 1.11 1.21; Deemester score was 37.65 14.54 and 4.89 6.39 (p-value is 0.0001) in GERD and non-GERD patients respectively.In GERD group, post treatment reflux symptom score(RSS) improved from 22.39 14.99 to 1.04 1.07, pulmonary symptom score(PSS) improved from 27.14 7.49 to 13.82 4.21 and night time asthma symptom score(NASS) improved from 6.71 1.80 to 3.04 1.23 (p-value <0.0001). After treatment, FEV1 and PEFR increased from 1.38 0.57 and 4.14 1.97 to 1.47 0.54 and 5.56 1.72, respectively (p-value 0.00114).PPI therapy improves nocturnal asthma symptoms, daytime asthma symptoms, pulmonary function and decreases requirement of asthma medications in these patients.


PubMed | Nair Hospital
Type: Journal Article | Journal: Gastroenterology research | Year: 2016

Pseudomelanosis duodeni is a rare, benign condition of unknown etiology. It is characterized by collection of pigment-laden macrophages in the tips of duodenal villi. The pigment, originally interpreted as melanin, pseudomelanin, lipomelanin or hemosiderin, has now been demonstrated to be mostly ferrous sulfide. There is a strong association with chronic renal failure, arterial hypertension, diabetes mellitus and the use of medications such as ferrous sulfate, hydralazine, propranolol, hydrochlorothiazide and furosemide. We reported a case of a 48 years old female who only had dyspeptic symptoms and no history of hypertension or drug history. Laboratory tests showed normal serum electrolytes and renal function. On endoscopy we found multiple tiny brownish-black pigmentation throughout proximal duodenum. Histopathological examination showed mild inflammation in lamina propria with haemosiderin-laden macrophages. Stain for iron was positive and that for melanin was negative.

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