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Chakraborty S.,Postgraduate Institute of Medical Education and ResearchChandigarh | Bhattacharyya R.,Maharishi Markandeshwar University | Sayal1 K.,Postgraduate Institute of Medical Education and ResearchChandigarh | Sayal1 K.,Indian Institute of Science | Banerjee D.,Postgraduate Institute of Medical Education and ResearchChandigarh
Current Pharmaceutical Biotechnology | Year: 2014

The scenario of tuberculosis has gone deadly due to its high prevalence and emergence of widespread drug resistance. It is now high time to develop novel antimycobacterial strategies and to understand novel mechanisms of existing antimycobacterial compounds so that we are equipped with newer tuberculosis controlling molecules in the days to come. Iron has proven to be essential for pathogenesis of tuberculosis and retinoic acid is known to influence the iron metabolism pathway. Retenoic acid is also known to exhibit antitubercular effect in in vivo system. Therefore there is every possibility that retinoic acid by affecting the iron metabolism pathway exhibits its antimycobacterial effect. These aspects are reviewed in the present manuscript for understanding the antimycobacterial role of retinoic acid in the context of iron metabolism and other immunological aspects. © 2014 Bentham Science Publishers. Source


Sinha M.B.,All India Institute of Medical Sciences | Gupta R.,Postgraduate Institute of Medical Education and ResearchChandigarh | Aggarwal A.,Postgraduate Institute of Medical Education and ResearchChandigarh | Sahni D.,Postgraduate Institute of Medical Education and ResearchChandigarh | Sinha H.P.,Postgraduate Institute of Medical Education and ResearchChandigarh
Journal of Morphological Sciences | Year: 2014

Background: We studied the bifurcation of sciatic nerve into two components which change their position throughout the early period of life. We proposed dimensions that would help reducing failure rates of anesthesia in popliteal fossa region and screening of malignancy related to sciatic nerve. Methods:The back of thigh and popliteal fossa of both sides of 50 fetuses (24 male and 26 female) were dissected. Skin over the gluteal region was dissected upto back of the knee. Sciatic nerve was traced from gluteal region to back of the thigh. The level where common fibular nerve and tibial nerve diverge from sciatic nerve and the diameter of sciatic nerve at various levels were evaluated. Results: In 97.7% (41/42) specimens,the bifurcation was above (5.1-20.86 mm) and in 2.3% (1/42) specimens, it was below (2.37 mm) the lateral condyle of femur. In 66% cases, sciatic nerve splits into two at or within 11 mm proximal to lateral condyle, while in 75% cases within 13mm, and in 100% cases within 21mm proximal to lateral condyle. Conclusion: This study provides quantitative data about the sciatic nerve in the gluteal region and back of the thigh. This data has a significant implication in diagnostic and anesthetic practice. © 2014, Brazilian Society of Anatomy. All rights reserved. Source


Mohindra S.,Postgraduate Institute of Medical Education and ResearchChandigarh | Gupta B.,Postgraduate Institute of Medical Education and ResearchChandigarh | Gupta K.,Postgraduate Institute of Medical Education and ResearchChandigarh | Bal A.,Postgraduate Institute of Medical Education and ResearchChandigarh
Respiratory Care | Year: 2014

This article reports an unusual case of tracheal mucormycosis following H1N1 pneumonia and reviews previously reported cases. A 40-y-old female with a 5-y history of diabetes mellitus, adequately controlled by oral hypoglycemic agents, developed tracheal mucormycosis after successful treatment for H1N1 pneumonia. The condition was diagnosed during workup for decannulation due to subglottic and upper tracheal obstruction by necrotic chewing gum-like tissue and cartilage. The patient was managed successfully by treatment with amphotericin B and surgical intervention in the form of laryngofissure and Montgomery tube placement. A review of the literature revealed only 5 previously reported cases of tracheal mucormycosis. A high degree of suspicion, early endoscopy and biopsy, histopathological evidence of the infection, and early institution of therapy are the keys to successful outcome. © 2014 Daedalus Enterprises. Source


Taneja N.,Postgraduate Institute of Medical Education and ResearchChandigarh | Mishra A.,Postgraduate Institute of Medical Education and ResearchChandigarh | Kumar A.,Postgraduate Institute of Medical Education and ResearchChandigarh | Verma G.,Postgraduate Institute of Medical Education and ResearchChandigarh | Sharma M.,Postgraduate Institute of Medical Education and ResearchChandigarh
Indian Journal of Medical Research, Supplement | Year: 2015

Background and objectives: There is a worldwide emergence of fluoroquinolone resistance in Shigella species. To understand the molecular mechanisms associated with fluoroquinolone resistance, naturally occurring fluoroquinolone-resistant strains and laboratory-induced spontaneous mutants of Shigella spp. were used and the relative contributions of acrAB-tolC efflux pumps, gyrase and topoisomerase target gene mutations towards fluoroquinolone resistance were determined. Methods: Eight Shigella flexneri and six S. dysenteriae clinical isolates were studied. Three consecutive mutants resistant to ciprofloxacin for S. flexneri SFM1 (≥0.25 μg/ml), SFM2 (≥4 μg/ml) and SFM3 (≥32 μg/ml) were selected in 15 steps from susceptible isolates by serial exposure to increasing concentrations of nalidixic acid and ciprofloxacin. Similarly, two mutants for S. dysenteriae SDM1 (≥0.25 μg/ml) and SDM2 (≥4 μg/ml) were selected in eight steps. After PCR amplification sequence analyses of gyrase and topoisomerase target genes were performed. Expression of efflux genes acrA, acrB, acrR and tolC was measured using real-time PCR. Results: Mutations were observed in gyrA Ser83→Leu, Asp87→Asn/Gly, Val196→Ala and in parC Phe93→Val, Ser80→Ile, Asp101→Glu and Asp110→Glu. Overall, acrA and acrB overexpression was associated with fluoroquinolone resistance (p<0.05); while tolC and acrR expression levels did not. Interpretation and conclusions: Fluoroquinolone resistance in Shigella spp. is the end product of either a single or a combination of mutations in QRDRs and/or efflux activity. Novel polymorphisms were observed at Val196→Ala in gyrA in clinical isolates and Phe93→Val, Asp101→Glu, Asp110→Glu and in parC in majority of laboratory-grown mutants. © 2015, Indian Council of Medical Research. All rights reserved. Source


Gupta R.,Postgraduate Institute of Medical Education and ResearchChandigarh | Singh H.,Postgraduate Institute of Medical Education and ResearchChandigarh | Kalia S.,Postgraduate Institute of Medical Education and ResearchChandigarh | Singh R.,Postgraduate Institute of Medical Education and ResearchChandigarh | Verma G.R.,Postgraduate Institute of Medical Education and ResearchChandigarh
Indian Journal of Gastroenterology | Year: 2015

Background Chylothorax is an uncommon complication of esophagectomy. It carries significant morbidity and mortality. The predisposing factors are ill-defined. Methods We retrospectively evaluated the data of 45 patients of carcinoma esophagus who underwent esophagectomy after neoadjuvant chemoradiotherapy (NACRT) from January 2010 to July 2012 in our tertiary health care center. Results Four patients (8.88%) had chylothorax. On analysis of perioperative factors, it was found that patients with chylothorax had tumor in middle third of thoracic esophagus (100%), shown partial response to neoadjuvant chemoradiation (NACRT) (100%) and were associated with difficult mediastinal dissection (75%) leading to higher blood loss requiring transfusion unlike those without chylothorax. There was no significant difference in the incidence of chylothorax following transhiatal, 3/35=8.57% or transthoracic esophagectomy 1/10=10% (p=0.898). Three patients were managed by transabdominal en masse ligation of tissue between aorta and azygos veinwhile one patient wasmanaged conservatively. Patients were discharged after a mean hospital stay of 15.5 days. The 30-day mortality rates in the two groups were similar (0% vs. 4.8%). Conclusion Difficult mediastinal dissection during esophagectomy in middle esophageal cancer may lead to thoracic duct injury. Complete response to NACRT may reduce the risk of chylothorax. Early transabdominal en masse ligation carries excellent results. Low output fistula following thoracic duct injury can be managed conservatively. © Indian Society of Gastroenterology 2015. Source

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