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Mathur T.,SMS Medical College and Hospital
BMJ case reports | Year: 2013

Spontaneous thrombosis of intracranial aneurysm is a rare event but is frequent after subarachnoid haemorrhage (SAH) and in fusiform or giant saccular aneurysms. We report a case of a 20-year-old man presenting with SAH due to rupture of a giant aneurysm of the middle cerebral artery. Initial CT angiography (CTA) revealed partially thrombosed MCA aneurysm but digital subtraction angiography performed 3 days later revealed complete occlusion of the aneurysm. Rapid thrombosis of aneurysm within 3 days has not been reported in literature so far. Source


Sharma P.,SMS Medical College and Hospital | Panwar M.,SMS Medical College and Hospital
Journal of Cataract and Refractive Surgery | Year: 2013

Purpose: To study the effect of injecting trypan blue 0.1% into the capsular bag on posterior capsule opacification (PCO) in eyes having phacoemulsification with foldable intraocular lens (IOL) implantation. Setting: Department of Ophthalmology, SMS Medical College & Hospital, Jaipur, India. Design: Comparative case series. Methods: Eyes having phacoemulsification were randomized to have 0.2 mL of trypan blue 0.1% injected subcapsularly at 2 sites 180 degrees apart after cortical-cleaving hydrodissection (trypan blue group) or 0.2 mL of a balanced salt solution injected in a similar fashion (control group). Six- and 12-month postoperative PCO was analyzed by a masked examiner using public-domain open-source software (ImageJ) on digital retroillumination images. The PCO score ∑ [% area × PCO grade (0 to 4)] was compared between the groups using the paired t test. Results: The trypan blue group comprised 150 eyes and the control group, 150 eyes. The mean patient age was 62.79 years ± 8.89 (SD) and 63.69 ± 9.20 years, respectively. After applying exclusion criteria, the mean PCO scores at 6 months and 12 months were 0.10 and 0.15, respectively, in the trypan blue group (102 eyes) and 0.21 and 0.25, respectively, in the control group (103 eyes). The difference was statistically significant at 6 months (P=.042) and 12 months (P=.0227). Two eyes in the trypan blue group and 6 eyes in the control group required laser capsulotomy. Conclusion: Intraoperative injection of trypan blue 0.1% into the capsular bag reduced PCO after phacoemulsification with foldable hydrophilic acrylic IOL implantation. Financial Disclosure: Neither author has a financial or proprietary interest in any material or method mentioned. © 2013 ASCRS and ESCRS. Source


Rao R.S.,SMS Medical College and Hospital
The Indian journal of chest diseases & allied sciences | Year: 2011

Sildenafil has been found to improve exercise capacity and haemodynamic parameters in patients with various pulmonary disorders. This study was undertaken to evaluate its efficacy in severe chronic obstructive pulmonary disease (COPD). In this double-blind, randomised, placebo-controlled study, 37 patients with severe COPD received either sildenafil or placebo for 12 weeks. Distance covered in six-minute walk test (6MWD) was taken as primary end-point. Pulmonary artery pressure (PAP) was measured as secondary end point. Thirty-three patients (15 in sildenafil arm and 18 in placebo arm) completed the study. Non-parametric tests were used for comparison. There was significant increase in 6MWD from baseline after three months of follow-up in sildenafil users (median change in distance covered in six-minute walk test (delta6MWD) = 190m) as compared to placebo users (delta6MWD = 0m, p < 0.05). The PAP decreased significantly (chi2 = 14.94, p < 0.05) in sildenafil group after three months, while it did not change significantly among placebo group (chi2 = 3.84, p > 0.05). Sildenafil improved 6MWD and PAP in patients with severe COPD. Source


Jaiswal M.,SMS Medical College and Hospital | Mittal R.S.,SMS Medical College and Hospital
Asian Spine Journal | Year: 2013

Gunshot wound (GSW) to the spine which was earlier common in the military population is now being increasingly noted in civilians due to easy availability of firearms of low velocity either licensed or illegal combined with an increased rate of violence in the society. Contributing to 13% to 17% of all spinal injuries, the management of complex injury to the spine produced by a GSW remains controversial. Surgery for spinal cord injuries resulting from low velocity GSWs is reserved for patients with progressive neurologic deterioration, persistent cerebrospinal fluid fistulae, and sometimes for incomplete spinal cord injuries. Surgery may also be indicated to relieve active neural compression from a bullet, bone, intervertebral disk, or a hematoma within the spinal canal. Spinal instability rarely results from a civilian GSW. Cauda equina injuries from low velocity GSWs have a better overall outcome after surgery. In general, the decision to perform surgery should be made on consideration of multiple patient factors that can vary over a period of time. Although there have been plenty of individual case reports regarding GSW to the spine, a thorough review of unique mechanical and biological factors that affect the final outcome has been lacking. We review the key concepts of pathogenesis and management of GSW to the spine and propose an algorithm to guide decision making in such cases © 2013 by Korean Society of Spine Surgery. Source


Gupta P.,Malaviya National Institute of Technology, Jaipur | Singh S.,SMS Medical College and Hospital | Kumar S.,Malaviya National Institute of Technology, Jaipur | Choudhary M.,Malaviya National Institute of Technology, Jaipur | Singh V.,SMS Medical College and Hospital
Journal of Asthma | Year: 2012

Objective. Sandstorms frequently cause adverse health effects especially in patients with asthma. The aim of our research was to explore the mechanism of sandstorm-induced asthmatic exacerbation by administering dust aerosol through an environmentally controlled exposure chamber. Methods. Four samples of soil (Ganganagar clay, Bikaner sand, Jaipur sand, and Ganganagar sand) were collected from three sandstorm-prone areas of Rajasthan, the desert state of India. Twenty patients with asthma, who had stable disease with a forced expiratory volume in first second (FEV1) more than 70% of predicted, volunteered to participate in this randomized single-blind placebo-controlled crossover study. The four samples of dust and placebo were administered randomly on 5 study days. FEV1 was measured for the next 60 minutes and the maximal decline in FEV1 (ΔFEV1) from baseline was measured. The samples of dust were also analyzed for particle size and adhesiveness. Results. The maximal decline in FEV1 was observed 15 minutes post-exposure with all dust samples. Mean ΔFEV1 was 0.69 ± 0.08 liters for Ganganagar clay, 0.52 ± 0.06 liters for Bikaner sand, 0.39 ± 0.07 liters for Jaipur sand, and 0.32 ± 0.04 liters for Ganganagar sand dust aerosol samples. Decline in FEV1 correlated with volume of dust particles with size <10 μm (PM10) and adhesiveness of the dust particles. Conclusion. Smaller-size sandstorm dust particles with higher adhesive properties have a greater potential of aggravating asthma. © 2012 Informa Healthcare USA, Inc. Source

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