Haryana, India
Haryana, India

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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.


Wadhera R.,Pt. BDS PGIMS Rohtak | Gulati S.P.,Pt. BDS PGIMS Rohtak | Kalra V.,Pt. BDS PGIMS Rohtak | Ghai A.,Pt. BDS PGIMS Rohtak
Egyptian Journal of Ear, Nose, Throat and Allied Sciences | Year: 2015

Isolated frontal sinus aspergillosis is extremely uncommon. Frontal sinus is commonly involved secondarily in association with other sinuses. A case of isolated frontal sinus aspergillosis is being reported which presented as Pott's puffy tumor. Frontal sinus exploration was done under general anesthesia. A small focus of the osteomyelitic bone in the anterior wall of the frontal sinus was removed. The fungus ball filling the left frontal sinus was removed. © 2015.


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
International Journal of Pediatric Otorhinolaryngology | Year: 2013

The incidents of foreign body ingestion in infants and children are usually viewed as accidents, but these events may be a form of child abuse. We are reporting a case of child abuse who presented with multiple foreign bodies in the gastrointestinal tract. Physicians are required to report abuse when they have reason to believe or to suspect that it occurred. The purpose of reporting is not punishment of the perpetrator - it is the protection of the child. It is certainly in the best interest of the child, because child abuse is a recurrent and usually escalating problem that exposes the child to substantial risk. © 2012 Elsevier Ireland Ltd.


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 .


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: 2012

Malignant oropharyngeal tumors are far more common compared to benign tumors. Oropharyngeal papilloma is typically present in adults. We are reporting a case of a big solitary papilloma arising from uvula in a 7-year-old male child. It was excised under general anesthesia. © 2012 Egyptian Society of Ear, Nose, Throat and Allied Sciences.


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.


PubMed | Pt. BDS PGIMS Rohtak
Type: Case Reports | Journal: International journal of pediatric otorhinolaryngology | Year: 2013

The incidents of foreign body ingestion in infants and children are usually viewed as accidents, but these events may be a form of child abuse. We are reporting a case of child abuse who presented with multiple foreign bodies in the gastrointestinal tract. Physicians are required to report abuse when they have reason to believe or to suspect that it occurred. The purpose of reporting is not punishment of the perpetrator - it is the protection of the child. It is certainly in the best interest of the child, because child abuse is a recurrent and usually escalating problem that exposes the child to substantial risk.


PubMed | Pt. BDS PGIMS Rohtak
Type: Journal Article | Journal: Clinica chimica acta; international journal of clinical chemistry | Year: 2012

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.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 Students 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.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.Raised CSF LDH and CSF protein levels may indicate CNS involvement in patients with ALL.


PubMed | Pt. B.D.S. PGIMS Rohtak
Type: Journal Article | Journal: Infectious disorders drug targets | Year: 2015

Acinetobacter species are ubiquitous in the environment and are important causative agent for nososcomial infection especially in immunocompromised patients. Multi drug resistant Acinetobacter lwoffii are emerging as a pathogen in neoanatal sepsis.This study was aimed to evaluate the clinical and antibiotic profile of Acinetobacter lwoffii.This study was done on blood samples from neonates admitted to neonatal intensive care unit during a period of one year from January to December 2012, who developed Acinetobacter infection. The diagnosis of isolates and antibiotic susceptibility testing was done by both conventional as well as by automated system.Out of total 13,133 blood samples received for culture, 1418(10.8%) were from NICU. Ninety (6.3%) isolates were found to be positive for the growth of Acinetobacter species. Of these isolates 31.11% were found to be Acinetobacter lwoffii, 68.9% were Acinetobacter baumannii calcaetius complex. Acinetobacter lwoffii isolates were most commonly sensitive to imepenem 16(57%), cotrimoxazole 9(32%), ciprofloxacin 6(21%) followed by amoxyclavulanic acid 2(7%) and cefuroxime 1(3.5%).Multi drug resistant Acinetobacter lwoffii infection is increasing particularly in premature and very low-birth weight neonates. Judicious and timely antibiotic use in NICUs are one of the important key in controlling multi-drug resistant Acinetobacter infection and improving clinical outcome.

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