NKP Salve Institute of Medical Science

Nāgpur, India

NKP Salve Institute of Medical Science

Nāgpur, India
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Onkar D.P.,NKP Salve Institute of Medical science | Govardhan S.A.,SDKS Dental College
Journal of Morphological Sciences | Year: 2013

Introduction: Spleen is the largest secondary lymphatic organ in the body designed to respond immunologically to antigens circulating in blood. Spleen performs important functions such as red blood cells production, their destruction, blood filtration, storage of blood and phagocytosis. Most of the textbooks of microscopic anatomy show picture of human spleen as the combination of findings derived from various animals. Aim: The present study was undertaken to compare histological difference between human and dog spleen as they differ according to their functions. Material and methods: Five mature dog and five normal human spleens were procured and were kept in Bouin's fluid for fixation. Sections were cut after paraffin embedding. Slides were stained by Haematoxylene and Eosin, Masson's Trichrome, Gordon and Sweet's reticular stain and observed under light microscope. Results: Capsule and trabeculae contains collagen and elastic fibers with few smooth muscle fibers in human spleen while in dog spleen more smooth muscle fibers and few elastic fibers were present. White pulp was more in human than dog. Red pulp and marginal zone of dog spleen showed ellipsoids and penicillar arteries which were poorly defined in human spleen. Red pulp showed prominent venous sinuses in dog spleen than human. Conclusion: Histological features are well defined in storage type of spleen as in dog than the defensive human spleen. Histological features of dog spleen are useful in better understanding of microscopic anatomy and can be used for teaching purpose.


PubMed | PSG Institute of Medical science and Research, NKP Salve Institute of Medical science, Baby Memorial Hospital, Katihar Medical College and 7 more.
Type: Journal Article | Journal: Indian journal of dermatology, venereology and leprology | Year: 2016

Stevens-Johnson syndrome and toxic epidermal necrolysis are severe, life-threatening mucocutaneous adverse drug reactions with a high morbidity and mortality that require immediate medical care. The various immunomodulatory treatments include systemic corticosteroids, cyclosporine, intravenous immunoglobulin, cyclophosphamide, plasmapheresis and tumor necrosis factor- inhibitors.The ideal therapy of Stevens-Johnson syndrome/toxic epidermal necrolysis still remains a matter of debate as there are only a limited number of studies of good quality comparing the usefulness of different specific treatments. The aim of this article is to comprehensively review the published medical literature and frame management guidelines suitable in the Indian perspective.The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) assigned the task of preparing these guidelines to its special interest group on cutaneous adverse drug reactions. The group performed a comprehensive English language literature search for management options in Stevens-Johnson syndrome/toxic epidermal necrolysis across multiple databases (PubMed, EMBASE, MEDLINE and Cochrane) for keywords (alone and in combination) and MeSH items such as guidelines, Stevens-Johnson syndrome, toxic epidermal necrolysis, corticosteroids, intravenous immunoglobulin, cyclosporine and management. The available evidence was evaluated using the strength of recommendation taxonomy and graded using a three-point scale. A draft of clinical recommendations was developed on the best available evidence which was also scrutinized and critically evaluated by the IADVL Academy of Dermatology. Based on the inputs received, this final consensus statement was prepared.A total of 104 articles (meta-analyses, prospective and retrospective studies, reviews [including chapters in books], previous guidelines [including Indian guidelines of 2006] and case series) were critically evaluated and the evidence thus gathered was used in the preparation of these guidelines.This expert group recommends prompt withdrawal of the culprit drug, meticulous supportive care, and judicious and early (preferably within 72 h) initiation of moderate to high doses of oral or parenteral corticosteroids (prednisolone 1-2 mg/kg/day or equivalent), tapered rapidly within 7-10 days. Cyclosporine (3-5 mg/kg/day) for 10-14 days may also be used either alone, or in combination with corticosteroids. Owing to the systemic nature of the disease, a multidisciplinary approach in the management of these patients is helpful.


PubMed | Washington University in St. Louis, Cincinnati Childrens Hospital Medical Center, University of Alabama at Birmingham, Mahatma Gandhi Institute and 11 more.
Type: Journal Article | Journal: BMC pregnancy and childbirth | Year: 2016

The first minutes after birth are critical to reducing neonatal mortality. Helping Babies Breathe (HBB) is a simulation-based neonatal resuscitation program for low resource settings. We studied the impact of initial HBB training followed by refresher training on the knowledge and skills of the birth attendants in facilities.We conducted HBB trainings in 71 facilities in the NICHD Global Network research sites (Nagpur and Belgaum, India and Eldoret, Kenya), with a 6:1 ratio of facility trainees to Master Trainers (MT). Because of staff turnover, some birth attendants (BA) were trained as they joined the delivery room staff, after the initial training was completed (catch-up initial training). We compared pass rates for skills and knowledge pre- and post- initial HBB training and following refresher training among active BAs. An Objective Structured Clinical Examination (OSCE) B tested resuscitation skill retention by comparing post-initial training performance with pre-refresher training performance. We identified factors associated with loss of skills in pre-refresher training performance using multivariable logistic regression analysis. Daily bag and mask ventilation practice, equipment checks and supportive supervision were stressed as part of training.One hundred five MT (1.6 MT per facility) conducted initial and refresher HBB trainings for 835 BAs; 76% had no prior resuscitation training. Initial training improved knowledge and skills: the pass percentage for knowledge tests improved from 74 to 99% (p<0.001). Only 5% could ventilate a newborn mannequin correctly before initial training but 97% passed the post-initial ventilation training test (p<0.0001) and 99% passed the OSCE B resuscitation evaluation. During pre-refresher training evaluation, a mean of 6.7 (SD 2.49) months after the initial training, 99% passed the knowledge test, but the successful completion rate fell to 81% for the OSCE B resuscitation skills test. Characteristics associated with deterioration of resuscitation skills were BAs from tertiary care facilities, no prior resuscitation training, and the timing of training (initial vs. catch-up training).HBB training significantly improved neonatal resuscitation knowledge and skills. However, skills declined more than knowledge over time. Ongoing skills practice and monitoring, more frequent retesting, and refresher trainings are needed to maintain neonatal resuscitation skills.ClinicalTrials.gov Identifier: NCT01681017 ; 04 September 2012, retrospectively registered.


PubMed | PSG Institute of Medical science and Research, NKP Salve Institute of Medical science, Baby Memorial Hospital, Katihar Medical College and 7 more.
Type: | Journal: Indian journal of dermatology, venereology and leprology | Year: 2016

Stevens-Johnson syndrome and toxic epidermal necrolysis are severe, life-threatening mucocutaneous adverse drug reactions with a high morbidity and mortality that require immediate medical care. The various immunomodulatory treatments include systemic corticosteroids, cyclosporine, intravenous immunoglobulin, cyclophosphamide, plasmapheresis and tumor necrosis factor- inhibitors.The ideal therapy of Stevens-Johnson syndrome/toxic epidermal necrolysis still remains a matter of debate as there are only a limited number of studies of good quality comparing the usefulness of different specific treatments. The aim of this article is to comprehensively review the published medical literature and frame management guidelines suitable in the Indian perspective.The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) assigned the task of preparing these guidelines to its special interest group on cutaneous adverse drug reactions. The group performed a comprehensive English language literature search for management options in Stevens-Johnson syndrome/toxic epidermal necrolysis across multiple databases (PubMed, EMBASE, MEDLINE and Cochrane) for keywords (alone and in combination) and MeSH items such as guidelines, Stevens-Johnson syndrome, toxic epidermal necrolysis, corticosteroids, intravenous immunoglobulin, cyclosporine and management. The available evidence was evaluated using the strength of recommendation taxonomy and the evidence was graded using a three-point scale. A draft of clinical recommendations was developed on the best available evidence which was also scrutinized and critically evaluated by the IADVL Academy of Dermatology. Based on the inputs received, this final consensus statement was prepared.A total of 104 articles (meta-analyses, prospective and retrospective studies, reviews [including chapters in books], previous guidelines [including Indian guidelines of 2006] and case series) were critically evaluated and the evidence thus gathered was used in the preparation of these guidelines.This expert group recommends prompt withdrawal of the culprit drug, meticulous supportive care, and judicious and early (preferably within 72 h) initiation of moderate to high doses of oral or parenteral corticosteroids (prednisolone 1-2 mg/kg/day or equivalent), tapered rapidly within 7-10 days. Cyclosporine (3-5 mg/kg/day) for 10-14 days may also be used either alone, or in combination with corticosteroids. Owing to the systemic nature of the disease, a multidisciplinary approach in the management of these patients is helpful.


Raje M.G.,NKP Salve Institute of Medical science
Journal of Indian Academy of Forensic Medicine | Year: 2011

Tendency to commit serious & trivial errors while certifying death still looms large. So some one may say, there is only one certificate in the world which is full of errors and that is death certificate! This study is done to evaluate errors in medical & non-medical part and to assess causes of errors of COD. Total 353 death certificates from teaching hospital were evaluated to detect different errors. Causes of errors of COD were scrutinized & confirmed after examining COD statements extensively. 21% death certificates were incompletely written. 99% certificates were incorrectly written. P value of correct & complete certificates with that of incorrect & incomplete certificates was found insignificant. Commonest error was use of 'with' instead of 'due to' & mention of 'MOD' at I a. Causes of these errors (99%) were Lack of training & diagnostic difficulty. Several errors were found in non-medical part which highlight 'routine attitude' of certifier. To change this scenario team work is needed. Team of doctors need to certify & supervise death certificates closely. Possibility of legal action against often erring certifying doctor may be appraised publically.


Kulkarni M.V.,NKP Salve Institute of Medical science | Durge P.M.,NKP Salve Institute of Medical science
Studies on Ethno-Medicine | Year: 2011

Present study was undertaken to find out prevalence of reproductive health morbidities among unmarried adolescent girls and to study the health care seeking behaviour during period of reproductive illness. A cross- sectional community based study was carried out in an urban slum field practice area under Urban Health Training Centre, Dept. of Community Medicine, NKP Salve Institute of Medical Science, Nagpur from June 2009 to February 2010. Out of five slum areas under field practice area, one area was selected by simple random sampling. The population of the selected area was 3000. All unmarried, non-pregnant, non-lactating adolescent girls (10 to 19 years) with attainment of menarche at least one year prior to the study were included in the study (n=224).Information regarding reproductive morbidities was collected in pre-designed and pre-tested pro-forma.Statistical analysis was done by epi- info statistical software. Out of total 224 girls, 146(65.18%) girls were having one or more reproductive morbidity. A high prevalence of dysmenorrhoea (53.6%) was reported among adolescent girls. Backache was found to be a second common morbidity. A highly significant statistical association was found between age of girl and dysmenor-rhoea. A highly significant statistical association was found between education of girl and reproductive morbidity.Out of 146 girls with reproductive morbidities, only 55(33.67%) girls sought heath care and 91(62.33%) girls remained silent without seeking health care. Out of 91 girls who did not seek health care 88(96.70%) girls reported 'no need of treatment' as a reason for not seeking health care. A high prevalence of reproductive morbidities was found among adolescent girls but heath care seeking behaviour was found to be very low. © Kamla-Raj 2011.


Swarnakar R.,NKP Salve Institute of Medical science | Sinha S.,KRIMS Hospitals
Lung India | Year: 2013

An endobronchial leiomyoma is a rare tumor of the bronchial tree. Very few cases have been reported in literature. Leiomyomas account for less than 2% of all benign lung tumors. Only one third is endobronchial in location, usually presenting as primary solitary lesions and airway obstruction findings. Literature on primary endobronchial leiomyomas is therefore scarce, with a few more than 100 cases being reported. These tumors arise from the smooth muscle of the bronchial tree. Symptomatology is based on the degree of endoluminal bronchial obstruction and surgical resection has generally been the mainstay of treatment. We describe a case of endobronchial leiomyoma in a 42 year old female. A diagnosis of Primary endobronchial leiomyoma was made on the basis of histopathology and immunohistochemistry. Rarity of this tumor in the bronchial tree with coexisting interstitial peumonitis urges us to report this case.


Subramaniam G.,Midas Children Hospital | Girish M.,NKP Salve Institute of Medical science
Indian Journal of Pediatrics | Year: 2015

Iron deficiency is not just anemia; it can be responsible for a long list of other manifestations. This topic is of great importance, especially in infancy and early childhood, for a variety of reasons. Firstly, iron need is maximum in this period. Secondly, diet in infancy is usually deficient in iron. Thirdly and most importantly, iron deficiency at this age can result in neurodevelopmental and cognitive deficits, which may not be reversible. Hypochromia and microcytosis in a complete blood count (CBC) makes iron deficiency anemia (IDA) most likely diagnosis. Absence of response to iron should make us look for other differential diagnosis like β thalassemia trait and anemia of chronic disease. Celiac disease is the most important cause of true IDA not responding to oral iron therapy. While oral ferrous sulphate is the cheapest and most effective therapy for IDA, simple nonpharmacological and pharmacological measures can go a long way in prevention of iron deficiency. © 2015, Dr. K C Chaudhuri Foundation.


Khandelwal R.,NKP Salve Institute of Medical science
BMJ case reports | Year: 2012

Badminton is a famous sport usually played without any protective eyewear. Ocular injury from one's own partner in a doubles game, with the shuttlecock, is rare. Two untrained badminton players presented with severe ocular trauma during a smash shot from the partner in a 'doubles' game. Both the players developed blind eye (vision <3/60) in spite of immediate treatment. This article describes an unusual mode of severe blunt trauma with a shuttlecock while playing a 'doubles' game, leading to coup-countercoup injury. In addition, the article highlights the need for awareness of the fatal ocular complications and life-long visual disability, especially in untrained badminton enthusiasts.


PubMed | NKP Salve Institute of Medical science, Nanyang Technological University, Singapore National Eye Center, Moorfields Eye Hospital and Tan Tock Seng Hospital
Type: Journal Article | Journal: Survey of ophthalmology | Year: 2016

Traumatic hyphemas present dilemmas to physicians. There are numerous controversies pertaining to the optimal approach to traumatic hyphema and no standardized guidelines for its management. We address some of these controversies and present a pragmatic approach. We discuss various medical agents and surgical techniques available for treatment, along with the indications for their use. We address the complications associated with hyphema and how to diagnose and manage them and consider the management of hyphema in special situations such as in children and sickle-cell anemia and in rare clinical syndromes such as recurrent hyphema after placement of anterior chamber intraocular lenses.

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