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Rohtak, India

Singla R.,Pt BDS PGIMS Rohtak
Chinese journal of traumatology = Zhonghua chuang shang za zhi / Chinese Medical Association | Year: 2013

The combination of ipsilateral humeral fractures at three different levels namely proximal, shaft and supracondyle has been rarely defined in the literature. We present a case report on such a complex injury in a 10-year-old child after falling down from the second floor of his house while playing. To the best of our knowledge, no such case report exists in the English literature. We define it as double floating arm injury. Firstly, shaft of humerus was open reduced and fixed with 4.5 mm narrow dynamic compression plate. Then closed reduction and pinning of the supracondylar humerus under an image intensifier was obtained. Open reduction using deltopectoral approach to the proximal humerus was done and the fracture was fixed with three K-wires. Ipsilateral multiple fractures in children often result from high energy trauma. Immediate reduction and fixation is required. Usually surgeons need to treat simple fractures firstly, which makes the subsequent treatment of complex fractures easier.

Wadhera R.,19 9J | Gulati S.P.,19 9J | Kalra V.,19 9J | Ghai A.,Pt BDS PGIMS Rohtak
International Journal of Pediatric Otorhinolaryngology Extra | Year: 2012

Wegener's granulomatosis (WG) is a fatal disease. Facial nerve paralysis in association with WG is rare, being present in about 5% of patients, alone or in combination with hearing loss and rarely may be the only presenting feature. We are reporting a case of WG presenting with bilateral facial paresis and its peculiarity consists in its acute onset, lack of a significant previous history of ear disease and its association with bilateral profound sensorineural hearing loss. A Medline search revealed that there has been no reported case of WG presenting with bilateral facial involvement with bilateral profound sensorineural hearing loss. © 2011 Elsevier Ireland Ltd.

Ghai A.,Pt. B.D. Sharma PGIMS Rohtak | Kumar H.,Pt. B.D. Sharma PGIMS Rohtak | Karwasra R.K.,Pt BDS PGIMS Rohtak | Kad N.,Pt. B.D. Sharma PGIMS Rohtak | And 2 more authors.
Anaesthesia, Pain and Intensive Care | Year: 2015

Objectives: Celiac plexus neurolysis is adjunct modality to relieve intractable pain caused by upper abdominal malignancy. An anterior approach offers advantages including shorter procedure time, less discomfort and less risk of neurological complications. The CT and ultrasound help to improve visualization of the celiac plexus. Their use allow accurate needle placement and reduce the risks. We report our experience with sonographically guided anterior approach to celiac plexus neurolysis in upper abdominal malignancy patients. Methodology: Patients with upper abdominal malignancy with VAS ≥3 not responding to diclofenac and demanding additional opioids or those having adverse effects were included. A prognostic block was performed under deep sedation with sonographic guidance using 22G, 15cm long Chiba needle advanced through biopsy guide to the preaortic zone above takeoff of celiac artery. Thirty to forty ml of 50% alcohol was injected. The VAS scores, analgesic consumption, duration of complete and partial pain relief were assessed at one hour, 24 hours, one week, one month, two month and three month intervals. Results: Fifteen patients were enrolled There was statistically significant decrease in mean VAS score at 1st hour, 24th hour, 1st week, 1st, 2nd and 3rd month respectively (p< 0.05). The analgesic consumption was statistically significant at all time intervals from baseline (p< 0.05). Conclusion: Use of color doppler helps in real time positioning of needle It is successful in terminally ill patients.

Rao D.,Pt BDS PGIMS Rohtak | Ghalaut V.S.,Pt BDS PGIMS Rohtak | Ghalaut P.S.,Pt BDS PGIMS Rohtak | Rao S.,Pt BDS PGIMS Rohtak
Clinica Chimica Acta | Year: 2012

Background: Central nervous system (CNS) involvement is common in hemoncologic diseases especially in patients with acute lymphocytic leukemia (ALL). Currently available modalities have limitations in diagnosing CNS involvement in early stages of disease and have a limited prognostic value. Raised cerebrospinal fluid (CSF) total lactate dehydrogenase (LDH) levels can predict CNS involvement in patients with various neurological disorders including CNS leukemia. Methods: This study was conducted in 23 consecutive freshly diagnosed patients of ALL without any previous CNS disease. Analysis of CSF was done for total LDH, proteins and electrolytes in all the patients before the start of chemotherapy and when the patients were in remission or 6. weeks after chemotherapy whichever was earlier. Twenty-three age and sex matched controls were also studied to set the normal reference range. The results were analyzed statistically by Student's t test and coefficient of co-relation between CSF LDH and protein in patients with raised CSF LDH at the time of presentation was also calculated. Results: CSF LDH was increased in 4 out of 6 patients with signs and symptoms of CNS involvement (Group A) and 3 of these patients also had increased CSF protein levels. 2 out of 17 patients without signs and symptoms of CNS involvement (Group B) had both elevated CSF LDH and protein levels. The increased levels came down to normal reference values after chemotherapy except in one Group A patient in whom CSF LDH remained high. However, no significant change in CSF electrolytes was noted in these patients. Conclusion: Raised CSF LDH and CSF protein levels may indicate CNS involvement in patients with ALL. © 2012 Elsevier B.V.

Wadhera R.,Pt BDS PGIMS Rohtak | Kalra V.,Pt BDS PGIMS Rohtak | Gulati S.P.,Pt BDS PGIMS Rohtak | Ghai A.,Pt BDS PGIMS Rohtak
Egyptian Journal of Ear, Nose, Throat and Allied Sciences | Year: 2013

Infectious mononucleosis is a viral infection, caused by Epstein-Barr virus, which is characterized by fever, sore throat, lymphadenopathy and atypical lymphocytosis. Bilateral quinsies associated with infectious mononucleosis are described very rarely. Bilateral quinsies are difficult to diagnose clinically because of lack of hallmark signs of peritonsillar abscess and, serious complications can occur due to delayed diagnosis. This is the first reported case of infectious mononucleosis that presented with bilateral sinus formation due to spontaneous rupture of bilateral quinsies. © 2012 .

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