Amritsar, India
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Khanna A.,SGRDIMSR | Khanna M.,SGRDIMSR | Aggarwal A.,SGRDIMSR Sri Guru Ram Das Institute of Medical science and Research
Journal of Clinical and Diagnostic Research | Year: 2013

Background: In November 2011, 6 patients who were in the ICU of the Sri Guru Ram Dass Institute of Medical Sciences and Research acquired an infection which was caused by Serratia marcescens. We investigated the cause of the increase in fre-quency of the isolation of Serratia marcesens from hospitalized patients. Methods: Various samples from patients and environmental sources, which were collected from the ICU of Sri Guru Ram Das Institute of Medical Sciences and Research during the 6 month period from November 2011 to April 2011, were included in the study. The isolates from the patients and the surround-ing environmental sources were examined by using standard techniques. Further, the isolates of Serratia marcescens were identified, depending upon their biochemical and morphological characteristics. Results: Seven isolates of Serratia marcescens were identified (six from the patients in the ICU and one from the soap dis-penser in the ICU) among a total of 327 isolates from the clinical samples and 84 isolates were identified from the environmental sources in the ICU. Discussion and Conclusion: An outbreak of the Serratia marc-escens infection in the ICU was traced to the extrinsic contami-nation of the soap dispenser in the ICU, as after the removal of the dispenser, no further case occurred.


Bhalla A.,SGRDIMSR | Mannan R.,SGRDIMSR | Khanna M.,SGRDIMSR | Bhasin T.S.,SGRDIMSR
Journal of Clinical and Diagnostic Research | Year: 2010

Tuberculosis caused by Mycobacterium tuberculosis is a prevalent infectious disease in resource challenged countries such as India. Tuberculosis of the female genital tract accounts for a minority of cases. Tuberculosis can have a varied presentation and can even mimic malignancy on clinical presentation, as illustrated by the following 2 cases. The first case was that of a 58 year old female presenting with a prolapsed uterus and a decubitus ulcer which was posted for surgical repair. However, on surgery, a diagnosis of frozen pelvis was made because of adhesions and suspicion of malignancy was high. In the second case, a 38 year old female presented in the gynaecology outpatient department with complains of menometrorrhagia. Her pelvic examination revealed a friable papillary growth on the cervix. The clinical differentials in this case included neoplastic and viral aetiologies. The histopathological diagnosis in both the cases after taking into consideration the history, clinical findings and other ancillary investigations was given as tubercular cervicitis. Ancillary investigations are necessary to exclude other causes of granulomatous inflammation such as Chlamydia trachomatis, Neisseria gonorrhea, Trichomonas vaginalis and Herpes simplex. Various studies have emphasized that the presence of typical granulomas are sufficient for the diagnosis of tuberculosis if other causes of granulomatous cervicitis are excluded. A high index of suspicion for tuberculosis is justified while dealing with cervical lesions in tuberculosis endemic areas.


Anand V.,SGRDIMSR | Sarin V.,SGRDIMSR | Singh B.,SGRDIMSR
Indian Journal of Otolaryngology and Head and Neck Surgery | Year: 2014

Adenoid hypertrophy treatment is must to alleviate chronic nasal obstruction, mouth breathing, rhinosinusitis and eustachian tube dysfunction. For proper management of this clinical entity a thorough clinical examination along with radiological and endoscopic evaluation is mandatory. Although, few children having adenoid hypertrophy respond to medical treatment, surgery remains the mainstay. An adenoidectomy can be performed by variety of techniques. Conventional adenoidectomy is by the curettage method, still practiced in many institutions, though, a recent technique of endoscopic assisted adenoidectomy by microdebrider is also getting popularized. Both the techniques have their own merits and demerits. However, which of the two surgical techniques is better, is still a matter of preference and experience of the surgeon with the technique. In the present study we will compare the conventional curettage adenoidectomy with endoscopically assisted adenoidectomy done with microdebrider in 40 pediatric patients of adenoid hypertrophy. © 2013, Association of Otolaryngologists of India.


Khanna A.,SGRDIMSR | Singh N.,SGRDIMSR | Aggarwal A.,SGRDIMSR | Khanna M.,SGRDIMSR
Journal of Clinical and Diagnostic Research | Year: 2012

Members of the genus, Citrobacter, a gram negative, non- sporing rod which belongs to the family, Enterobacteriaceae are emerging as important nosocomial pathogens. The study was carried out to determine the frequency and the anti-microbial sensitivity pattern of the Citrobacter species among the various gram negative isolates which were obtained from different clinical samples. Out of the total 1830 gram negative bacilli which were isolated over a period of one and half year, from February 2010 to August 2011, from various clinical samples which were submitted to the microbiology laboratory of the Sri Guru Ram Das Hospital, eighty six (4.70%) isolates belonged to the Citrobacter species, of which 58 were Citrobacter freundii and 28 were Citrobacter koseri. Sixty three (73.26%) out of 86 Citrobacter isolates were multi-drug resistant. There was a highly significant difference in the resistance of the Citrobacter isolates to all the antimicrobials including beta lactams, quinolones and aminoglycosides, among the hospital and outdoor isolates. ESBL production was seen in 61.64% of the hospital and in 30.70% of the outdoor isolates.


Sood A.S.,SGRDIMSR
Indian Journal of Otolaryngology and Head and Neck Surgery | Year: 2012

Though single sitting myringoplasty using temporalis fascia under general anesthesia has been documented in many studies, but ours is the first center to have started using tragal cartilage harvested from one ear to do bilateral myringoplasty in one sitting using local anesthesia with excellent results including very good graft uptake rate and audiological improvement without significant complications. © 2012 Association of Otolaryngologists of India.


Khanna A.,SGRDIMSR | Khanna M.,SGRDIMSR | Aggarwal A.,SGRDIMSR
Journal of Clinical and Diagnostic Research | Year: 2012

Rodutorula, a common saprophyte has recently emerged as an opportunistic pathogen in immunocompromised patients. Meningitis caused by Rodurorula species in HIV-1 infected patients have been reported rarely but rodutorula infection in HIV-2 infected patient has not been reported till date. We present a case of meningitis caused by Rodutorula rubra in a patient infected with HIV-2 virus. The diagnosis of the patient was confirmed by cell cytology, gram staining and culture of the CSF. Contamintion was ruled out by repeated culturing from different samples from the same patient. Therapy with Amphotericin B showed good results and the patient was discharged after recovery.


PubMed | SGRDIMSR
Type: Journal Article | Journal: Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India | Year: 2015

Adenoid hypertrophy treatment is must to alleviate chronic nasal obstruction, mouth breathing, rhinosinusitis and eustachian tube dysfunction. For proper management of this clinical entity a thorough clinical examination along with radiological and endoscopic evaluation is mandatory. Although, few children having adenoid hypertrophy respond to medical treatment, surgery remains the mainstay. An adenoidectomy can be performed by variety of techniques. Conventional adenoidectomy is by the curettage method, still practiced in many institutions, though, a recent technique of endoscopic assisted adenoidectomy by microdebrider is also getting popularized. Both the techniques have their own merits and demerits. However, which of the two surgical techniques is better, is still a matter of preference and experience of the surgeon with the technique. In the present study we will compare the conventional curettage adenoidectomy with endoscopically assisted adenoidectomy done with microdebrider in 40 pediatric patients of adenoid hypertrophy.


Sarin V.,SGRDIMSR | Singh B.,SGRDIMSR | Prasher P.,SGRDIMSR
Orbit | Year: 2010

Nasal chondromesenchymal hamartoma (NCMH) is a rare benign pediatric hamartoma that can simulate malignancy. It is apt to be misdiagnosed because of the overlapping histologic features shared with a number of benign and malignant soft tissue tumors. Here we report a case of this clinical entity in a child of 2.5 years of age. NCMH is histologically characterized by a mixture of various mesenchymal elements, including spindle cells, collagen fibers and irregular islands of osseous and chondroid tissue. The tissue was immunosensitive to SMA and calponin. This tumor has a benign biological behavior, and complete resection is the treatment of choice. Awareness of this clinical entity is essential for correct diagnosis and to avoid potentially harmful therapies. © 2010 Informa Healthcare USA, Inc.


PubMed | SGRDIMS&R, BPS Government Medical College and Government Medical College and Hospital
Type: Journal Article | Journal: Anesthesia, essays and researches | Year: 2016

The assessment of severity of low back pain includes subjective questionnaires to quantify the impact on routine life. The objective of current study was to correlate various quality of life (QOL) scores to the clinical outcome measured as improvement in Visual Analog Score (VAS) after interventional treatment.Fifty-one consecutive chronic low backache patients were assessed for pain intensity using VAS, revised Oswestry Disability Index (ODI), Quebecs, Roland-Morris disability questionnaire (RMDQ), and depression score at presentation. All subjects received interventional therapy complemented with physiotherapy; changes in scores were evaluated at 2 weekly intervals till 12 weeks.Prospective, observational, cohort study.All scores depicted highly significant statistical improvement over baseline scores (ODI and depression score closely parallel trends of reduction in VAS indicating that these scores may be the best outcome predictor after interventional treatment of pain. Among QOL scores ODI and RMDQ evaluated in the current study record comparable degree of physical incapacity; the exception is Quebecs score.


PubMed | General Motors and SGRDIMSR
Type: Journal Article | Journal: Iranian journal of otorhinolaryngology | Year: 2016

Deep neck space infections (DNSI) are serious diseases that involve several spaces in the neck. The common primary sources of DNSI are dental infections, tonsillar and salivary gland infections, malignancies, and foreign bodies. With widespread use of antibiotics, the prevalence of DNSI has been reduced. Common complications of DNSI include airway obstruction, jugular vein thrombosis, and sepsis. Treatment principally comprises airway management, antibiotic therapy, and surgical intervention. This study was conducted to investigate the age and sex distribution of patients, symptoms, presentation, sites involved, bacteriology, and management and complications of DNSI.This retrospective study was performed from October 2010 to January 2013, and included 76 patients with DNSI. Patients of all age groups and gender were included. All parameters including age, gender, co-morbidities, presentation, site, bacteriology, complications, and required interventions were studied.In our study, the majority of patients were in the 31-50-year age group. Males accounted for 55.26% of the sample and females for 44.74%, with a male:female ratio of 1.23. Most of the patients were from a rural background. Diabetes was found as a co-morbid condition in 10.52% cases. Neck pain was the most common symptom, identified in 89.47% cases. The most common etiological factor was odontogenic infection (34.21%), followed by tonsillar and pharyngeal infection (27.63%). The most common presentation was Ludwigs angina (28.94%), followed by peritonsillar abscess and submandibular abscess. In 50% of cases, Streptococcus and Staphylococcus were found in the culture. Surgical intervention was carried out in 89.47% cases. Emergency tracheotomy was required in 5.26% cases.DNSI can be life-threatening in diabetic patients, the immunocompromised, and elderly patients, and special attention should therefore be given to these groups. Early diagnosis and treatment is essential to prevent complications. All patients must be treated initially with intravenous antibiotics, with treatment subsequently updated based on a culture and sensitivity report. Due to poor oral hygiene, lack of nutrition, smoking and chewing of beetle nut and tobacco, odontogenic infections are the most common cause of DNSI. Thus, DNSI could be prevented by making the population aware of dental and oral hygiene and offering regular check-ups for dental infections.

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