RML Hospital

Delhi, India

RML Hospital

Delhi, India
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D'souza M.M.,INMAS | Choudhary A.,RML Hospital | Poonia M.,INMAS | Kumar P.,INMAS | Khushu S.,INMAS
Injury | Year: 2017

Background The ability of diffusion tensor imaging (DTI) to complement conventional MR imaging by diagnosing subtle injuries to the spinal cord is a subject of intense research. We attempted to study change in the DTI indices, namely fractional anisotropy (FA) and mean diffusivity (MD) after traumatic cervical spinal cord injury and compared these with corresponding data from a control group of individuals with no injury. The correlation of these quantitative indices to the neurological profile of the patients was assessed. Material and methods 20 cases of acute cervical trauma and 30 age and sex matched healthy controls were enrolled. Scoring of extent of clinical severity was done based on the Frankel grading system. MRI was performed on a 3T system. Following the qualitative tractographic evaluation of white matter tracts, quantitative datametrics were calculated. Results In patients, the Mean FA value at the level of injury (0.43+/−0.08) was less than in controls (0.62+/−0.06), which was statistically significant (p value <0.001). Further, the Mean MD value at the level of injury (1.30+/−0.24) in cases was higher than in controls (1.07+/−0.12, p value <0.001). Statistically significant positive correlation was found between clinical grading (Frankel grade) and FA values at the level of injury (r value = 0.86). Negative correlation was found between clinical grade and Mean MD at the level of injury (r value = −0.38) which was however statistically not significant. Conclusion Quantitative DTI indices are a useful parameter for detection of spinal cord injury. FA value was significantly decreased while MD value was significantly increased at the level of injury in cases as compared to controls. Further, FA showed significant correlation with clinical grade. DTI could thus serve as a reliable objective imaging tool for assessment of white matter integrity and prognostication of functional outcome. © 2017 Elsevier Ltd

PubMed | Armed Forces Medical College AFMC, Guru Gobind Singh Indraprastha University, Hindu Rao Hospital, Mar Thoma College and 4 more.
Type: Journal Article | Journal: Pregnancy hypertension | Year: 2016

Cell free fetal DNA (cffDNA) and its hypermethylated RASSF1A gene signify a recent advancement in non-invasive prenatal diagnosis of feto-placental anomalies like pre-eclampsia. The study uses hypermethylated RASSF1A gene to quantify cffDNA and to assess its relationship with placental and urine proteins in pre-eclampsia cases.DNA was isolated from plasma samples of clinically diagnosed cases of pre-eclampsia (n=103) and normal pregnancy (n=616) from 21weeks of gestation. Through methylation sensitive enzyme (BstUI) digestion; followed by real time-polymerase chain reaction (RT-PCR), quantification of hypermethylated RASSF1A was done. Immunoassays determined: placental protein-13 (pp-13) and pregnancy associated plasma protein A (PAPP-A) and pyrogallol red molybdate assay for 24h urine protein.Highly significant differences between control and pre-eclampsia cases for hypermethylated RASSF1A concentrations were found; Group I: 337.35 vs 74.4616.71, Group II: 53.7516.65 vs 244.2235.68, Group III: 93.2519.08 vs 412.3180.18, Group IV: 144.3018.13 vs 1056.89153.78, Group V: 307.5540.76 vs 2763.76259.76copies/ml. Multivariate Pearsons correlation analysis of hypermethylated RASSF1A with pp-13, PAPP-A and urine proteins showed positive and very highly significant (P<0.001) associations.Diagnostic potential of fetal specific, hypermethylated RASSF1A was evaluated. Its positive relationship with placental and urine proteins submit the case for considering it as a reliable marker for pre-eclampsia.

Kumar N.,AIIMS | Kataria H.,Lady Hardinge Medical College | Yadav C.,All India Institute of Medical Sciences | Gadagoli B.S.,RML Hospital | Raj R.,AIIMS
Journal of Clinical Orthopaedics and Trauma | Year: 2014

Background: Stable trochanteric femur fractures can be treated successfully with conventional implants such as sliding hip screw, cephalomedullary nails, angular blade plates. However comminuted and unstable inter or subtrochanteric fractures with or without osteoporosis are challenging & prone to complications. The PF-LCP is a new implant that allows angular stability by creating fixed angle block for treatment of complex, comminuted proximal femoral fractures. Method: We reviewed 30 patients with unstable inter or subtrochanteric fractures, which were stabilized with PF-LCP. Mean age of patient was 65 years, and average operative time was 80 min. Patients were followed up for a period of 3 years (June 2010-June 2013). Patients were examined regularly at 3 weekly interval for signs of union (radiological & clinical), varus collapse (neck-shaft angle), limb shortening, and hardware failure. Result: All patients showed signs of union at an average of 9 weeks (8-10 weeks), with minimum varus collapse (<10°), & no limb shortening and hardware failure. Results were analysed using IOWA (Larson) hip scoring. Average IOWA hip score was 77.5. Conclusion: PF-LCP represents a feasible alternative for treatment of unstable inter- or subtrochanteric fractures. © 2014 Delhi Orthopaedic Association.

Habib M.,RML Hospital | Tanwar Y.S.,RML Hospital | Jaiswal A.,Bokaro General Hospital | Singh S.P.,RML Hospital | And 2 more authors.
Bone and Joint Journal | Year: 2014

In order to achieve satisfactory reduction of complex distal humeral fractures, adequate exposure of the fracture fragments and the joint surface is required. Several surgical exposures have been described for distal humeral fractures. We report our experience using the anconeus pedicle olecranon flip osteotomy approach. This involves detachment of the triceps along with a sliver of olecranon, which retains the anconeus pedicle. We report the use of this approach in ten patients (six male, four female) with a mean age of 38.4 years (28 to 51). The mean follow-up was 15 months (12 to 18) with no loss to follow-up. Elbow function was graded using the Mayo Score. The results were excellent in four patients, good in five and fair in one patient. The mean time to both fracture and osteotomy union was 10.6 weeks (8 to 12) and 7.1 weeks (6 to 8), respectively. We found this approach gave reliably good exposure for these difficult fractures enabling anatomical reduction and bicondylar plating without complications. © 2014 The British Editorial Society of Bone & Joint Surgery.

Dhawan H.K.,PGIMER | Kumawat V.,Government Medical College | Marwaha N.,PGIMER | Sharma R.R.,PGIMER | And 4 more authors.
Asian Journal of Transfusion Science | Year: 2014

Background: The development of anti-red blood cell antibodies (both allo-and autoantibodies) remains a major problem in thalassemia major patients. We studied the frequency of red blood cell (RBC) alloimmunization and autoimmunization among thalassemia patients who received regular transfusions at our center and analyzed the factors, which may be responsible for development of these antibodies. Materials and Methods: The study was carried out on 319 multiply transfused patients with β-thalassemia major registered with thalassemia clinic at our institute. Clinical and transfusion records of all the patients were examined for age of patients, age at initiation of transfusion therapy, total number of blood units transfused, transfusion interval, status of splenectomy or other interventions. Alloantibody screening and identification was done using three cell and 11 cell panel (Diapanel, Bio-rad, Switzerland) respectively. To detect autoantibodies, autocontrol was carried out using polyspecific coombs (IgG + C3d) gel cards. Results: Eighteen patients out of total 319 patients (5.64%) developed alloantibodies and 90 (28.2%) developed autoantibodies. Nine out of 18 patients with alloantibodies also had autoantibodies. Age at first transfusion was significantly higher in alloimmunized than non-immunized patients (P = 0.042). Out of 23 alloantibodies, 52.17% belonged to Rh blood group system (Anti-E = 17%, Anti D = 13%, Anti-C = 13%, Anti-C w = 9%), 35% belonged to Kell blood group system, 9% of Kidd and 4% of Xg blood group system. Conclusion: Alloimmunization was detected in 5.64% of multitransfused thalassemia patients. Rh and Kell blood group system antibodies accounted for more than 80% of alloantibodies. This study re-emphasizes the need for RBC antigen typing before first transfusion and issue of antigen matched blood (at least for Rh and Kell antigen). Early institution of transfusion therapy after diagnosis is another means of decreasing alloimmunization. © 2014 Asian Journal of Transfusion Science. All right reserved.

Yadav S.,Dr N C Joshi Memorial Hospital | Gupta N.,RML Hospital
The Pan African medical journal | Year: 2014

Testicular tumors are very common among man under the age of 45 years. The case of bilateral synchronous testicular seminoma is very rare. We present a case of bilateral synchronous testicular seminoma stage-I in a 42-year old Indian male who came to our hospital with chief complaints of dull ache in the abdomen and groin, bilateral scrotal swelling and heaviness, left-sided scrotal swelling since last four years, and right-sided since last two years. He underwent bilateral orchidectomy followed by radiotherapy. In this case we throw light on this rare condition and discuss the management.

Singh S.,Institute of Nuclear Medicine and Allied Sciences | Goyal S.,RML Hospital | Modi S.,Institute of Nuclear Medicine and Allied Sciences | Kumar P.,Institute of Nuclear Medicine and Allied Sciences | And 4 more authors.
Neuroradiology | Year: 2014

Introduction: To investigate whether the motor functional alterations in schizophrenia (SZ) are also associated with structural changes in the related brain areas using functional magnetic resonance imaging (fMRI) and voxel-based morphometry (VBM). Methods: A sample of 14 right-handed SZ patients and 14 right-handed healthy control subjects matched for age, sex, and education were examined with structural high-resolution T1-weighted MRI; fMRI images were obtained during right index finger-tapping task in the same session. Results: fMRI results showed reduced functional activation in the motor areas (contralateral precentral and postcentral gyrus) and ipsilateral cerebellum in SZ subjects as compared to healthy controls (n=14). VBM analysis also revealed reduced grey matter in motor areas and white matter reduction in cerebellum of SZ subjects as compared to controls. Conclusion: The present study provides an evidence for a possible association between structural alterations in the motor cortex and disturbed functional activation in the motor areas in persons affected with SZ during a simple finger-tapping task. © 2014 Springer-Verlag.

Bansal C.,Ispat General Hospital | Lakshmaiah V.,Sri Devaraj Urs Medical College | Raavesha A.,Sri Devaraj Urs Medical College | Waadhawan P.,Rml Hospital | Priyanka M.K.,Sri Devaraj Urs Medical College
Journal of Association of Physicians of India | Year: 2013

Tuberous sclerosis is 2nd most common neurocutaneous syndrome. Bilateral renal angiomyolipoma in tuberous sclerosis is a rare entity. Reporting two cases of tuberous sclerosis with bilateral renal angiomyolipomas. © JAPI.

PubMed | Assam Medical College, Dr Ram Manohar Lohia & Postgraduate Institute of Medical Education & Research and RML Hospital
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2016

Sinonasal tumours present a myriad of radiographic findings. While many of these tumours have been well described with regard to their typical sites of origin, age group and radiological appearance we have come across lesions in our daily practice which are exceedingly rare with regard to site of origin in sinonasal cavity. The radiological appearances of 4 such rare and unusual tumours arising in sinonasal region evaluated by cross sectional imaging (CT/MRI) have been illustrated in this article with a purpose to review the radio-pathological correlation of these tumours and to explain the utility of cross-sectional imaging CT and MRI in exploring diagnostic clues. Morphological features and radiological patterns of each tumour have been graded into mild, moderate and severe based on the extent of tumoural involvement. This review is intended to acquaint radiologists with the appearance of atypical sinonasal masses and their radiological appearance on cross sectional imaging to make an early diagnosis.

Rameshchandra Ramavat P.,Rml Hospital | Rameshchandra Ramavat M.,GMERS Medical College Patan | Wasudeo Ghugare B.,GMERS Medical College | Uttam Joshi M.,Oral Medicine and Radiology MP Dental College and Hospital
Journal of Clinical and Diagnostic Research | Year: 2013

Context: Diabetic Retinopathy (DR) can be defined as a damage which is caused to microvasculature in the retina by prolonged hyperglycaemia. Various studies have been conducted in south India, to find out prevalence of DR. It remains a less explored domain among type 2 diabetic patients in western India. Objectives: (1) To assess prevalence of diabetic retinopathy in type 2 DM in western Indian population. and (2) To find out effect of duration of diabetes on severity of DR in this population. Study Design: A hospital - based, cross - sectional study. Materials and Methods: A total of 168 patients with type 2 DM underwent detailed opthalmoscopic examinations for DR. The ETDRS classification was followed to categorize retinopathy in different stages. Results: We observed that overall, prevalence of DR in type 2 patients of western India was 33.9%. Prevalences of non-proliferative DR and proliferative DR were 25.5% and 8.33% respectively. Statistically significant differences (p value<0.05) were observed between prevalences of DR in each group of patients which was classified, and duration of diabetes. Prevalence of CSME (clinically significant macular oedema) was 6.5%. Associated hypertension showed a statistically significant (p value<0.05%), higher prevalence of DR. Conclusion: This study concluded that prevalence of DR in type 2 DM patients of western India was 33.9% and that it increased with duration of diabetes. Associated hypertension is a risk factor for development of DR. It was further noted that proliferative DR was prevalent only after having diabetes for 11 years.

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