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Kumar L.,Shri Guru Ram Rai Institute of Medical and Health science | Husain M.,Jn Medical College | Ahmad I.,Jn Medical College
Journal of the Indian Medical Association | Year: 2012

The study was conducted at JNMC, Aligarh, India, to discern the obstacles/hurdles that stood in the way of the patients and the high technology diagnostic tool. For this purpose several parameters were taken eg, education/ literacy, occupation and income group, etc. From the study 97% chose to undergo USG and only 3% were defaulters; 86% chose to undergo CT scan and only 14% were defaulters; 79% chose to undergo MRI and 21% were defaulters. Low cost investigations ie, USG and CT scan were more prescribed to IVth social class but MRI was mostly prescribed to IInd. Most of the defaulters were from IVth social class and showed financial problem for getting investigation. Taking into consideration the cost and sensitivity of procedure, it was found in this study that mainly cost determines the outcome. Sensitivity did not matter in patient's perspective. This was the reason that maximum defaulters were found in MRI, followed by CT scan and least in USG. Financial constraint was primary reason declared by defaulters followed by distance. Additional parameters like literacy, occupation and social standing were also found significant in the study in the sense of prescription of investigation and being defaulter.

Dutta S.,Shri Guru Ram Rai Institute of Medical and Health science
Romanian Journal of Morphology and Embryology | Year: 2010

Variation arterial anatomy of suprarenal gland is significant for radiological and surgical interventions. Knowledge of anomalous suprarenal artery is required to avoid complications in surgical procedure. Arterial architecture of human suprarenal gland was studied in sixty-eight cadavers of adult male and female. In all cases, superior suprarenal artery on right side was normal in origin but on left side, 24% showed anomalous origin. The incidence of anomalous origin of middle suprarenal artery on right side was 47% and on left side 6%. Anomalous origin of inferior suprarenal artery on the right side was 29% and left side 35%. The superior suprarenal artery was present in all subjects. However, there was absence of right middle suprarenal artery in 29% and left inferior suprarenal artery in 35% subjects. The most variable group was inferior suprarenal artery. The study result is being described to report anomalous origin of suprarenal arteries in the light of surgical, radiological and embryological significances. Present study findings suggest, thorough knowledge of anomalous arterial anatomy of suprarenal gland is required for surgical and radiological interventions of retroperitoneal organs of upper abdomen to avoid complications.

Mathur A.V.,Shri Guru Ram Rai Institute of Medical and Health science
Indian Journal of Surgical Oncology | Year: 2015

One of the criteria for recommending cholecystectomy for silent gall stones, is gall stones in regions with high incidence of gall bladder cancer. Both gall stones and gall bladder cancer are common in North India. All tertiary care centres in India report high rates of gall bladder cancer (GBC) incidence and poor treatment outcomes in the majority of cases due to advanced stage of presentation. Csendes of Chile has reported very high incidence of gallbladder cancer in Chile and Bolivia and advocated prophylactic cholecystectomy in asymptomatic patients. Incidence rate of gall bladder cancer in Indian males is equal to that of Chile, whereas in females, the rates are almost double the rates of Chile. Indians have also been found to have high concentrations of heavy metals in gall bladder wall, and antibodies to tumor suppressor genes. In India, gall bladder cancer is the commonest GI cancer in women and fourth commonest cancer overall in the female population. In view of the epidemiology and clinical scenario of gall bladder cancer and proven safety of laparoscopic cholecystectomy, there is a need to act before it is too late in the current rates of gall bladder cancer. This study looks at the evidence correlating gall stones and gall bladder cancer, in relation to India. There is pressing evidence today to justify a strategy of prophylactic cholecystectomy in silent gall stones in North India. Data for this study was selected through an internet based search for literature concerning gall stones and gall bladder cancer in India, and for prophylactic cholecystectomy. © 2015, Indian Association of Surgical Oncology.

Dutta S.,Shri Guru Ram Rai Institute of Medical and Health science | Mukerjee B.,Vinayak Mission
Jornal Vascular Brasileiro | Year: 2010

Background: Anatomic variations of the hepatic arteries are common. Preoperative identification of these variations is important to prevent inadvertent injury and potentially lethal complications during open and endovascular procedures. Objective: To evaluate the incidence, extra-hepatic course, and presence of side branches of accessory hepatic arteries, defined as an additional arterial supply to the liver in the presence of normal hepatic artery. Methods: Eighty-four human male cadavers were dissected using a transperitoneal midline laparotomy. The supra-celiac aorta, celiac axis, and hepatic arteries were dissected, and their trajectories were identified to describe arterial branching patterns. Results: Normal hepatic arterial anatomy was identified in 95% of the cadavers and six (5%) had accessory hepatic arteries. In five cadavers the accessory hepatic artery followed its course through the fissure for ligamentum venosum, and in one it coursed adjacent to the hepatic artery through the margin of the lesser omentum. One cadaver had a single side branch, which provided arterial blood supply to the left adrenal gland in the absence of any left inferior phrenic artery. Conclusion: Accessory hepatic artery most often follows the course of the hepatic fissure for ligamentum venosum. Albeit uncommonly found in 5% of cases, this finding should be identified during open and endovascular procedures to prevent inadvertent injury. © 2010 by Sociedade Brasileira de Angiologia e de Cirurgia Vascular.

Juyal D.,Veer Chandra Singh Garhwali Government Medical science and Research Institute | Thawani V.,Shri Guru Ram Rai Institute of Medical and Health science | Thaledi S.,Seema Dental College and Hospital | Joshi M.,Veer Chandra Singh Garhwali Government Medical science and Research Institute
Journal of Traditional and Complementary Medicine | Year: 2014

Taxus wallichiana Zucc., known as Himalayan yew, belongs to the family Taxaceae. It is a medium-sized, temperate, Himalayan forest tree of medicinal importance. In India, this evergreen tree is found at altitudes between 1800 and 3300 m above mean sea level (MSL). It has been used by the native populations for treating common cold, cough, fever, and pain. Its uses are described in Ayurveda and Unani medicine. It received attention recently as its leaves and bark were found to be the prime source of taxol, a potent anticancer drug. It possesses many other biological activities also. We focus on its importance in traditional medicine for its multiple medicinal properties. Copyright © 2014 Committee on Chinese Medicine and Pharmacy, Taiwan.

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