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.
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.
Udwadia Z.F.,nduja National Hospital And Medical Research Center |
Pinto L.M.,nduja National Hospital And Medical Research Center |
Uplekar M.W.,World Health Organization
PLoS ONE | Year: 2010
Setting: Mumbai, India. A study conducted in Mumbai two decades ago revealed the extent of inappropriate tuberculosis (TB) management practices of private practitioners. Over the years, India's national TB programme has made significant progress in TB control. Efforts to engage private practitioners have also been made with several successful documented public-private mix initiatives in place. Objective: To study prescribing practices of private practitioners in the treatment of tuberculosis, two decades after a similar study conducted in the same geographical area revealed dismal results. Methods: Survey questionnaire administered to practicing general practitioners attending a continuing medical education programme. Results: The participating practitioners had never been approached or oriented by the local TB programme. Only 6 of the 106 respondents wrote a prescription with a correct drug regimen. 106 doctors prescribed 63 different drug regimens. There was tendency to over treat with more drugs for longer durations. Only 3 of the 106 respondents could write an appropriate prescription for treatment of multidrug-resistant TB. Conclusions: With a vast majority of private practitioners unable to provide a correct prescription for treating TB and not approached by the national TB programme, little seems to have changed over the years. Strategies to control TB through public sector health services will have little impact if inappropriate management of TB patients in private clinics continues unabated. Large scale implementation of public-private mix approaches should be a top priority for the programme. Ignoring the private sector could worsen the epidemic of multidrug-resistant and extensively drug-resistant forms of TB. © 2010 Udwadia et al.
Shah S.A.V.,nduja National Hospital And Medical Research Center |
Kondkar A.A.,nduja National Hospital And Medical Research Center |
Ashavaid T.F.,nduja National Hospital And Medical Research Center
Scandinavian Journal of Clinical and Laboratory Investigation | Year: 2016
Background: With an increase in the discovery of newer genetic loci/polymorphisms in complex multifactorial diseases, there is also an increased need for methods that can simultaneously genotype multiple loci in a cost-effective manner. Using coronary artery disease (CAD) as a model, the study aimed to develop an in-house multilocus assay for simultaneous detection of 17 genetic variants in 11 genes implicated in CAD. Methods: A multiplex polymerase chain reaction (PCR)-based reverse line blot hybridization (MPCR-RLBH) approach was used, where each DNA sample was amplified using two separate MPCRs, and the alleles were genotyped using covalently immobilized, amino-linked sequence-specific oligonucleotide probes using an enhanced chemiluminescence system. The assay performance was tested on 75 healthy controls and 75 angiographically proven CAD cases. Validation was done by automated Sanger sequencing. Results: The assay could successfully discriminate both the alleles at CETP (I405V), LPL (D9N), NOS3 (T-786G and E298D), LIPC (C-514T), FGB (G-455A), ITGB3 (L33P), AGT (M235T), and MTR (A2756G) loci. Certain mutations included in this assay such as ins242G, ins397G, E387K, L393K in the LDLR; N291S in the LPL; D442G in the CETP; and T833C in the CBS genes were found to be absent. The genotype results obtained using this assay showed 100% concordance with sequencing. Conclusion: The study demonstrated development and validation of a multiplex SNP genotyping assay that can be used to assess genetic risk factors in CAD. The assay provides a cost-effective alternative to expensive high throughput genotyping systems in common molecular research laboratories. © 2016 Medisinsk Fysiologisk Forenings Forlag (MFFF)
Vadwai V.,nduja National Hospital And Medical Research Center |
Daver G.,nduja National Hospital And Medical Research Center |
Udwadia Z.,nduja National Hospital And Medical Research Center |
Sadani M.,nduja National Hospital And Medical Research Center |
And 2 more authors.
PLoS ONE | Year: 2011
Background: Unsuccessful treatment outcomes among patients with multi-/extensively- drug resistant tuberculosis (TB) have hampered efforts involved in eradicating this disease. In order to better understand the etiology of this disease, we aimed to determine whether single or multiple strains of Mycobacterium tuberculosis (MTB) are localized within lung cavities of patients suffering from chronic progressive TB. Methodology/Findings: Multiple cavity isolates from lung of 5 patients who had undergone pulmonary resection surgery were analyzed on the basis of their drug susceptibility profile, and genotyped by spoligotyping and 24-loci MIRU-VNTR. The patients past history including treatment was studied. Three of the 5 patients had extensive drug resistant TB. Heteroresistance was also reported within different cavity isolates of the lung. Both genotyping methods reported the presence of clonal population of MTB strain within different cavities of the each patient, even those reporting heteroresistance. Four of the 5 patients were infected with a population of the Beijing genotype. Post-surgery they were prescribed a drug regimen consisting of cycloserine, a fluoroquinolone and an injectable drug. A 6 month post-surgery follow-up reported only 2 patients with positive clinical outcome, showing sputum conversion. Conclusion: Identical spoligotype patterns and MIRU-VNTR profiles between multiple cavities of each patient, characterize the presence of clonal population of MTB strains (and absence of multiple MTB infection). © 2011 Vadwai et al.
Shrimal A.,nduja National Hospital and Medical Research Center |
Prasanth M.,nduja National Hospital and Medical Research Center |
Kulkarni A.V.,nduja National Hospital and Medical Research Center
Indian Journal of Surgery | Year: 2012
Hepatocellular carcinoma is the commonest primary liver tumor and its incidence is on an increase. Transplantation and surgical resection are the gold standard curative treatment options but less than 20%patients are surgical candidates because of advanced liver disease and/or co-morbidities. Various interventional radiological procedures have been developed and intensively investigated for treatment of inoperable HCC. This review summarizes the various interventional radiological treatments in HCC including patient selection, procedural considerations and response evaluation. Transarterial chemoembolization, radioembolization and radiofrequency ablation are mainly discussed. © 2011 Association of Surgeons of India.
Todur S.P.,nduja National Hospital And Medical Research Center |
Ashavaid T.F.,nduja National Hospital And Medical Research Center
Indian Journal of Clinical Biochemistry | Year: 2013
There is an increasing interest to understand the molecular basis of high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) subfractions and their association with coronary artery disease (CAD). The formation of these subfractions is greatly influenced by hepatic lipase (HL) and cholesteryl ester transfer protein (CETP) enzymes. To identify genetic markers influencing LDL and HDL subfractions and their role in CAD we performed a case-control genetic association study on 117 healthy controls and 119 angiographically verified CAD patients. Biochemical analysis was performed using standard assays. HDL-C and LDL-C subfractions were estimated using precipitation methods. Genotyping of C-514T (rs1800588) in the LIPC gene for HL and I405V (rs5882) in the CETP gene was done using PCR-based restriction enzyme analysis and sequencing. Both the polymorphisms were not associated with CAD. The C-514T was associated with increased HDL3-C levels in controls (P = 0.049). The I405V polymorphism was found to be associated with low levels of small dense, LDL (P = 0.038). A multiple regression analysis showed that the effects were dependent on gender and triglyceride levels. We conclude that these polymorphisms are not associated with CAD but are important determinants of HDL-C and small dense LDL particles in our population. © 2012 Association of Clinical Biochemists of India.
Shah R.S.,nduja National Hospital And Medical Research Center |
Sharma P.C.,nduja National Hospital And Medical Research Center |
Bhandarkar D.S.,nduja National Hospital And Medical Research Center
Journal of Indian Association of Pediatric Surgeons | Year: 2015
Aim: To review our experience of laparoscopic repair of Morgagni's hernia (MH) using transfascial sutures. Materials and Methods: This is a retrospective review of patients presenting to the first author with the diagnosis of MH over a 15-year period. The variables analyzed included demographic data, clinical presentation, and operative details. Results: In all there were five male with a median age of 2 years. They were asymptomatic and MH was detected incidentally by observing an air-filled density in the right cardiophrenic angle on plain X-ray of the chest. Computed tomography (CT) confirmed the diagnosis in all patients. All patients underwent laparoscopic repair of MH using transfascial sutures. The average operative time was 75 min. Oral feeding was started 6 h after surgery and patients were discharged on either 3rd or 4th postoperative day. Postoperative follow-up X-ray confirmed the intact repair. Conclusions: Laparoscopic repair of MH using transfascial sutures is an easy and effective solution. Multiple horizontal mattress sutures taking full thickness of abdominal wall muscles with the edge of the diaphragm leads to a strong repair. As sutures are tied extracorporeally, the technique is easily reproducible.
PubMed | nduja National Hospital And Medical Research Center
Type: | Journal: Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia | Year: 2017
We present our recent experience with fluorescein sodium videoangiography (FLVA) in the intra-operative evaluation of a patient with conus medullaris arteriovenous malformation (AVM). To our knowledge this is the first report in the literature of use of FLVA in the surgery of spinal AVM. Intra-operative FLVA was done to identify an early filling vessel and to obliterate the site of fistulous connection. This was correlated and confirmed with simultaneous indocyanine green videoangiography (ICGVA). The conus and cauda equina roots could be appreciated and manipulated in relation to this fluorescence. Obliteration was confirmed with FLVA and correlated with ICGVA. There was no untoward reaction to the dye injection. We conclude that FLVA is a useful adjunct in the surgical treatment of conus medullaris AVMs since it is a real time, noninvasive, radiation-free, easily reproducible technique allowing surgical manipulation through the operating oculars with simultaneous visualization of surrounding critical structures.