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PubMed | Narayana Hrudayalaya Hospitals, Grifols, Russian Academy of Medical Sciences, Ruby Hall Clinic and 2 more.
Type: Journal Article | Journal: Immunotherapy | Year: 2016

To assess safety and efficacy of a 10% intravenous immunoglobulin in patients with primary immune thrombocytopenic purpura (ITP).ITP patients in two multicenter studies (Trials A/B) were treated with 2 g/kg Flebogamma18 patients in Trial A and 58 in Trial B were enrolled (12 children in Trial B). The response rate (platelet count 50 10Flebogamma 10% DIF was effective and safe in patients with primary ITP.


Patil S.J.,Narayana Hrudayalaya Hospitals | Rai G.K.,Sanjay Gandhi Post Graduate Institute of Medical Sciences | Bhat V.,Narayana Hrudayalaya Hospitals | Ramesh V.A.,DNA Diagnostics Center | And 3 more authors.
American Journal of Medical Genetics, Part A | Year: 2014

Distal arthrogryposis syndromes (DAs) show wide clinical variability and overlapping clinical findings with the other DAs classified by Bamshad et al. [1996]. Most of the DAs are inherited as autosomal dominant disorders. DA type 5D is a subtype of DA type 5 inherited as autosomal recessive disorder, clinically characterized by congenital distal joint contractures, knee extension contractures, congenital hip dislocation, club foot, ptosis and other eye findings, furrowed tongue, and scoliosis. Here, we report on a family with clinical features of DA type 5D with novel mutations in the ECEL1 gene. © 2014 Wiley Periodicals, Inc.


Rao S.,Narayana Hrudayalaya Hospitals | D'Cruz A.L.J.,Narayana Hrudayalaya Hospitals | Aggarwal R.,Narayana Hrudayalaya Hospitals | Chandrashekar S.,Narayana Hrudayalaya Hospitals | And 3 more authors.
Journal of Indian Association of Pediatric Surgeons | Year: 2011

Background: Liver transplantation is well established worldwide as an effective treatment for end-stage liver disease in children. Acceptance in India has been slow because of considerations of cost, infections, inability to support long-term care, and non-availability of expertise. Aim: This study was designed to report our experience with pediatric liver transplantation. Materials and Methods: Twenty-eight children underwent liver transplantation. Results: Biliary atresia was the commonest indication (n = 15) followed by metabolic liver disease. Twenty-six children had living donor transplants, mothers being the donors in a majority of these. Common surgical complications included bile leaks (n = 3) and vascular problems (n = 6). Common medical complications included infections, acute rejection, and renal failure. Overall, patient survival was 71%, while that for the last 14 cases was 92%. All survivors are doing well, have caught up with physical and developmental milestones and are engaged in age appropriate activities. Conclusions: The study demonstrates the feasibility of a successful pediatric liver transplant program in our country.


Muralidhar K.,Narayana Hrudayalaya Hospitals and 258 A Bommasandra Industrial Area | Bhagyashri K.,Narayana Hrudayalaya Hospitals and 258 A Bommasandra Industrial Area | Guptha R.,Narayana Hrudayalaya Hospitals and 258 A Bommasandra Industrial Area | Hegde N.,Narayana Hrudayalaya Hospitals | And 2 more authors.
Asian Cardiovascular and Thoracic Annals | Year: 2013

Background: Acute renal injury requiring renal replacement therapy after cardiac surgery develops in 1%-5% of patients, and is strongly associated with perioperative morbidity and mortality. The prognostic risk factors for development acute renal injury requiring renal replacement therapy are identified in this study. Methods: 2585 adult patients who underwent cardiac surgery during a 1-year period (November 2010 to October 2011) were studied. The patients who developed acute renal injury requiring renal replacement therapy were compared with matched controls. Logistic regression analysis was applied to determine the predictors of acute renal injury requiring renal replacement therapy. Results: 44 patients developed acute renal injury requiring renal replacement therapy following cardiac surgery. On multivariate logistic analysis, the following factors independently predicted acute renal injury requiring renal replacement therapy (p0.05): preoperative critical state, pre-existing renal dysfunction, preoperative diastolic dysfunction, and combined cardiac surgery. Conclusion: The risk of acute renal injury requiring renal replacement therapy can be fairly accurately predicted and quantified on the basis of available preoperative and intraoperative data. These predictors may be used by physicians to estimate the risk and target high-risk groups for interventions that prevent, reduce, or ameliorate the occurrence of renal failure needing acute renal replacement therapy. © The Author(s) 2012 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.


PubMed | Apollo Hospitals and Narayana Hrudayalaya Hospitals
Type: Journal Article | Journal: Journal of vascular and interventional neurology | Year: 2015

A six-year-old boy was diagnosed as recurrent posterior circulation stroke secondary to basilar artery occlusion with rapid progression of symptoms. Etiology of stroke was a dissection of V3 segment of left vertebral artery, which was treated using endovascular technique 26 hours after worsening of symptoms. Since the guidelines for acute revascularization in pediatric stroke are not well established, there is limited experience in the use of mechanical devices for acute ischemic stroke revascularization in children. To our knowledge, this is one of the youngest reported cases of acute ischemic stroke from Asia managed with newer mechanical clot removal devices.


Mahadevan S.,Narayana Hrudayalaya Hospitals
Telemedicine journal and e-health : the official journal of the American Telemedicine Association | Year: 2012

We have used a telemedicine facility to conduct academic teaching/training sessions. The objective of this study was to examine the feasibility, advantages, and disadvantages of this method of e-learning sessions. The teaching/learning sessions were organized twice a week between the two teaching hospitals. The success of each academic session was analyzed in terms of satisfaction of the participating candidates, infrastructure difficulties (if any), and the overall outcome of the program. In total, 293 academic sessions were held from 2008 to 2010. Each session's presentation was 45 min long and was made using Microsoft(®) (Redmond, WA) PowerPoint. We have found that telemedicine proved to be effective in establishing communication not only between the patient and the physician, but also between the teacher and the student. Several candidates benefited from the application of this technology. Candidates expressed satisfaction and were content with the teaching methods adapted.


Patil S.J.,Narayana Hrudayalaya Hospitals | Madhusudhan B.G.,Narayana Hrudayalaya Hospitals | Shah S.,Narayana Hrudayalaya Hospitals | Suresh P.V.,Narayana Hrudayalaya Hospitals
American Journal of Medical Genetics, Part A | Year: 2012

Williams-Beuren syndrome (WBS) is one of the microdeletion syndromes associated with distinct facial features, characteristic behavior phenotype (overfriendly behavior), congenital heart disease, and other malformations. Clinical features in WBS are age dependent. It is important to be aware of variable age dependent phenotype, especially facial phenotype due to its crucial role in diagnosis. Here we describe the facial phenotype of WBS at different ages (3 months to 15.1 years) and congenital heart malformations in 27 patients FISH positive for 7q11.23 microdeletion. © 2012 Wiley Periodicals, Inc.


PubMed | Narayana Hrudayalaya Hospitals
Type: Journal Article | Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology | Year: 2016

e16000 Background: Squamous cell carcinoma of the gingivobuccal complex (GBC) is the most common oral cancer in India (Pathak et al. Head Neck 2005;27:597-602). Majority of patients with GBC are detected at an advanced stage (Pathak et al. Head Neck 2005;27:597-602). Locoregional recurrence remains the major problem after curative intent treatment (Pathak et al. Head Neck 2005;27:597-602). Advanced GBC tumors involve multiple structures and there is no study in literature that has systemically evaluated GBC tumors for pattern of invasion into various structures and extent of their involvement.All the patients underwent a standard surgical resection (compartmental resection). Surgically resected specimen was systemically evaluated for all the structures involved, their extent of involvement and their margin status. Detailed clinical history, findings of computed tomography scanning (CT scanning) and findings of pathologic evaluation were compared and results were evaluated.Twenty-six patients with advanced GBC tumors (stage T4) were included in this study. Skin and mandible were involved in 12 cases while pterygoid muscles in 20 cases and masseter muscle in 21 cases. Lymphnodes were involved in ten cases and in six instances only one lymphnode was positive. Imaging missed the diagnosis of Infratemporal fossa (ITF) involvement in 7 cases and recent onset trismus was a better marker to predict ITF involvement. Margins were positive in two cases.Advanced GBC tumors have significant soft tissue extension and involve multiple structures. They are locally aggressive cancers with low lymphnode involvement. [Table: see text].


PubMed | Narayana Hrudayalaya Hospitals
Type: Journal Article | Journal: Asian cardiovascular & thoracic annals | Year: 2014

Acute renal injury requiring renal replacement therapy after cardiac surgery develops in 1%-5% of patients, and is strongly associated with perioperative morbidity and mortality. The prognostic risk factors for development acute renal injury requiring renal replacement therapy are identified in this study.2585 adult patients who underwent cardiac surgery during a 1-year period (November 2010 to October 2011) were studied. The patients who developed acute renal injury requiring renal replacement therapy were compared with matched controls. Logistic regression analysis was applied to determine the predictors of acute renal injury requiring renal replacement therapy.44 patients developed acute renal injury requiring renal replacement therapy following cardiac surgery. On multivariate logistic analysis, the following factors independently predicted acute renal injury requiring renal replacement therapy (p<0.05): preoperative critical state, pre-existing renal dysfunction, preoperative diastolic dysfunction, and combined cardiac surgery.The risk of acute renal injury requiring renal replacement therapy can be fairly accurately predicted and quantified on the basis of available preoperative and intraoperative data. These predictors may be used by physicians to estimate the risk and target high-risk groups for interventions that prevent, reduce, or ameliorate the occurrence of renal failure needing acute renal replacement therapy.


PubMed | Narayana Hrudayalaya Hospitals
Type: Journal Article | Journal: Annals of cardiac anaesthesia | Year: 2013

Transoesophageal Echocardiography (TEE) is now an integral part of practice of cardiac anaesthesiology. Advances in instrumentation and the information that can be obtained from the TEE examination has proceeded at a breath-taking pace since the introduction of this technology in the early 1980s. Recognizing the importance of TEE in the management of surgical patients, the American Societies of Anesthesiologists (ASA) and the Society of Cardiac Anesthesiologists, USA (SCA) published practice guidelines for the clinical application of perioperative TEE in 1996. On a similar pattern, Indian Association of Cardiac Anaesthesiologists (IACTA) has taken the task of putting forth guidelines for transesophageal echocardiography (TEE) to standardize practice across the country. This review assesses the risks and benefits of TEE for several indications or clinical scenarios. The indications for this review were drawn from common applications or anticipated uses as well as current clinical practice guidelines published by various society practicing Cardiac Anaesthesia and cardiology . Based on the input received, it was determined that the most important parts of the TEE examination could be displayed in a set of 20 cross sectional imaging planes. These 20 cross sections would provide also the format for digital acquisition and storage of a comprehensive TEE examination. Because variability exists in the precise anatomic orientation between the heart and the esophagus in individual patients, an attempt was made to provide specific criteria based on identifiable anatomic landmarks to improve the reproducibility and consistency of image acquisition for each of the standard cross sections.

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