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Sen T.,nduja National Hospital And Medical Research Center
The Indian journal of chest diseases & allied sciences | Year: 2010

There has been a recent surge in the recognition of interstitial lung disease (ILD) in India. We conducted a retrospective study based on the available medical records of 274 patients with biopsy proven ILD seen during the period 1994-2001 at our tertiary care referral hospital. Idiopathic pulmonary fibrosis (43%), sarcoidosis (22%), ILDs secondary to collagen vascular disease (19%) and extrinsic allergic alveolitis, among others, were the most common aetiological causes of ILD. The diagnostic yield from transbronchial lung biopsy (TBLB) was high (96%). Interstitial lung diseases (ILDs) appear to be under-reported from India. Lack of recognition and inadequate availability of diagnostic facilities, like high resolution computed tomography (HRCT) of the chest may be some of the reasons for this. The diagnostic yield from TBLB in our study was high at 96 percent. The TBLB may be used as the initial, cost-effective and safe tool for confirmation of aetiological diagnosis in most patients with diffuse parenchymal lung diseases.

Chhabria M.A.,nduja National Hospital And Medical Research Center
The Journal of the Association of Physicians of India | Year: 2010

A 74 year old male patient with weight loss, diarrohea, loss of appetite, anemia, thrombocytopenia and culture negative endocarditis was diagnosed to have Whipple's disease. We are reporting this case, as it is a rare disease with fewer than 1000 validated cases reported in literature.

Rodrigues C.,nduja National Hospital And Medical Research Center | Desai N.,Rutgers University | Fernandes H.,Rutgers University
Clinical Microbiology Newsletter | Year: 2016

The advantages of molecular testing for accurate diagnosis and optimal therapeutic management of patients infected with microorganisms is well established, yet many test methods are not feasible in underdeveloped or resource-limited settings. The disparity in testing methods is controversial from ethical, financial, and scientific perspectives. Over the years, philanthropic funding for early and accurate diagnosis has helped curtail the spread of disease and improved overall survival, yet infections caused by microorganisms are still the leading cause of death in the resource-limited parts of the world. Fortunately, there are promising new tests that are inexpensive, portable, easy-to-use, and practical at even small, rural, and remote health centers. This review describes the potential problems encountered in the routine implementation and performance of molecular assays in resource-poor settings and discusses the adaptations and alternative methodologies that are routinely used in most microbiology laboratories in such settings. © 2016 Elsevier Inc.

Rawall S.,nduja National Hospital And Medical Research Center | Bali K.,Jawaharlal Institute of Postgraduate Medical Education & Research | Upendra B.,All India Institute of Medical Sciences | Garg B.,All India Institute of Medical Sciences | And 2 more authors.
Archives of Orthopaedic and Trauma Surgery | Year: 2012

Background Osteosynthesis in fracture neck of femur (NOF) in young is a universally acceptable procedure. Various factors affect the outcome; with AVN (avascular necrosis) and non-union primarily contributing to adverse results in such patients. To identify factors affecting outcome of displaced fracture NOF, a prospective cohort study was carried out in the setting of a tertiary care centre in developing country. Methods 27 consecutive patients with displaced fracture NOF suitable for osteosynthesis underwent closed reduction and fixation with three 6.5 mm cancellous cannulated screws. A record of posterior comminution and its extent (as seen on CT scan) and the intracapsular pressure difference between the fractured and the opposite side was kept in all the patients. The patients were followed-up for 1 year. The main outcomes measured at 1 year were nonunion (as identified by CT scan) and AVN (as identified by bone scan). Results Cases with pressure difference >30 mm were found to have a higher rate of AVN and this result was found to be statistically significant (p value 0.034). The patients with significant posterior comminution were found to have higher non-union rates and this result was also found to be statistically significant (p value 0.04). Conclusions Prognosis of displaced fracture NOF is significantly associated significant with posterior comminution and intracapsular pressure difference between fractured and normal side. © Springer-Verlag 2011.

Ajbani K.,nduja National Hospital And Medical Research Center | Lin S.-Y.G.,Microbial Diseases Laboratory | Rodrigues C.,nduja National Hospital And Medical Research Center | Nguyen D.,Microbial Diseases Laboratory | And 13 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2015

Reliable molecular diagnostics, which detect specific mutations associated with drug resistance, are promising technologies for the rapid identification and monitoring of drug resistance in Mycobacterium tuberculosis isolates. Pyrosequencing (PSQ) has the ability to detect mutations associated with first- and second-line anti-tuberculosis (TB) drugs, with the additional advantage of being rapidly adaptable for the identification of new mutations. The aim of this project was to evaluate the performance of PSQ in predicting phenotypic drug resistance in multidrug- and extensively drug-resistant tuberculosis (M/XDR-TB) clinical isolates from India, South Africa, Moldova, and the Philippines. A total of 187 archived isolates were run through a PSQ assay in order to identify M. tuberculosis (via the IS6110 marker), and to detect mutations associated with M/XDR-TB within small stretches of nucleotides in selected loci. The molecular targets included katG, the inhA promoter and the ahpC-oxyR intergenic region for isoniazid (INH) resistance; the rpoB core region for rifampin (RIF) resistance; gyrA for fluoroquinolone (FQ) resistance; and rrs for amikacin (AMK), capreomycin (CAP), and kanamycin (KAN) resistance. PSQ data were compared to phenotypic mycobacterial growth indicator tube (MGIT) 960 drug susceptibility testing results for performance analysis. The PSQ assay illustrated good sensitivity for the detection of resistance to INH (94%), RIF (96%), FQ (93%), AMK (84%), CAP (88%), and KAN (68%). The specificities of the assay were 96% for INH, 100% for RIF, FQ, AMK, and KAN, and 97% for CAP. PSQ is a highly efficient diagnostic tool that reveals specific nucleotide changes associated with resistance to the first- and second-line anti-TB drug medications. This methodology has the potential to be linked to mutation-specific clinical interpretation algorithms for rapid treatment decisions. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

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