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Khadilakar M.S.,Smt Kashibai Navale Medical College And General Hospital
Journal of orthopaedic surgery (Hong Kong) | Year: 2012

Extra-osseous tenosynovial chondromatosis is rare and has a high rate of local recurrence. We report a 23-year-old man who presented with a 6-month history of pain and swelling of the right middle finger and painful limitation of the ring finger flexion secondary to this condition. Surgical exploration revealed multiple loose bodies of varying size arising from the flexor tendon sheath. Histopathological examination revealed mature chondroid tissue and focal calcification. After 2 years of follow-up, the patient had achieved an excellent functional recovery and showed no evidence of recurrence.


Deshmukh S.D.,Smt Kashibai Navale Medical College and General Hospital
Hand surgery : an international journal devoted to hand and upper limb surgery and related research : journal of the Asia-Pacific Federation of Societies for Surgery of the Hand | Year: 2013

The most common soft tissue sarcomas of hand are epitheloid sarcomas, synovial sarcomas and malignant fibrous histiocytomas which are high grade, aggressive tumors. Liposarcomas of the hand are extremely rare and to the best of our knowledge less than 20 cases have been reported so far in the literature. Well differentiated spindle cell liposarcoma is an extremely rare subtype of well differentiated liposarcoma/atypical lipomatous tumor which is different from the other subtypes clinicopathologically, genetically and prognostically. Palmar localization of this rare variant of liposarcoma at this site makes ours only the second case reported in the world literature so far. This recently described entity is low grade lesion and the hand surgeons need to adopt a less aggressive approach in the treatment of this subtype.


Anand M.,Smt Kashibai Navale Medical College And General Hospital
The Indian journal of chest diseases & allied sciences | Year: 2011

Congenital cystic adenomatoid malformation (CCAM) encompasses a continuum of hamartomatous cystic lung lesions characterised by the presence of abnormal bronchiolar structures of varying sizes or distribution. The CCAM is a disorder of infancy with majority of the cases being diagnosed within the first two years of life. We describe CCAM in a 13-year-old girl complaining of recurrent lower respiratory tract infections since infancy who presented with post-infectious pneumatocele with loculated pleural effusion, and suspected abscess formation and had undergone resection.


Pradhan N.P.,Smt Kashibai Navale Medical College And General Hospital | Bhat S.M.,Smt Kashibai Navale Medical College And General Hospital | Ghadage D.P.,Smt Kashibai Navale Medical College And General Hospital
Journal of Association of Physicians of India | Year: 2014

Results: A total of 366 ICU patient records were analysed. Of these, 32 patients were found to have developed 35 nosocomial infections (9.6% prevalence), of which respiratory infections were the commonest (65.8%), followed by urinary infections (17.1%) and dual infections (urinary plus respiratory) (17.1%). The most frequently isolated microorganism causing respiratory infections was Acinetobacter (40.4%), 21% isolates of which were multidrug resistant; whereas the most frequently isolated microorganism causing urinary tract infections was Pseudomonas (38.4%). Average ICU stay in patients with and without nosocomial infections was 16.5 and 6.4 days respectively; whereas mortality in the two groups was 28.1% and 31.2% respectively. Overall ICU mortality was 19.9%.Objectives: 1. To study the prevalence of nosocomial infections in the Medical ICU. 2. To determine common microorganisms causing nosocomial infections in the ICU and their antibioticsensitivity profile. 3. To study the impact of nosocomial infections on ICU stay and mortality.Methods: A retrospective 1 year analysis of nosocomial infections in the Medical ICU at Smt. Kashibai Navale Medical College and Hospital, Pune, between January and December 2011 was carried out. Prevalence of nosocomial infections was determined; sites of nosocomial infections and common causative microorganisms were identified; their antibiotic-sensitivity profiles were studied. The group of patients with nosocomial infections was matched with a control group drawn from the pool of patients without nosocomial infections; this matching was done with respect to age, gender and clinical diagnosis. Period of ICU stay and patient mortality rates in the two groups were analysed.Conclusion: The nosocomial infection rate in our ICU was in keeping with the rate in many industrialised countries. The most common site of nosocomial infection was the respiratory tract, followed by the urinary tract. Acinetobacter was the commonest respiratory isolate, whereas Pseudomonas was the commonest urinary isolate. One fourth of Acinetobacter isolates were multidrug resistant. Nosocomial infections resulted in a statistically significant increase in ICU stay; whereas there was no impact on ICU mortality. © 2014, Journal of the association of physicians of India. All rights reserved.


Naik C.,Smt Kashibai Navale Medical College And General Hospital | Nemade S.,Smt Kashibai Navale Medical College And General Hospital
European Archives of Oto-Rhino-Laryngology | Year: 2016

Use of endoscope in middle ear surgery is not new, yet there is resistance to its use in stapedotomy. This is due to perceived long learning curve in shifting from conventional microscope to the endoscope and fear of one-handed work. (1) to present a case series of endoscopic stapedotomies and analyze the operative findings. (2) Discuss the merits and demerits of same. 20 patients with otosclerosis underwent stapedotomy over 5 years using 0°, 4 mm nasal endoscope of 18 cm length. Visualization of middle ear structures, surgical steps, operative time, hearing results and complications were analyzed. In all 20 cases, (13 males, 7 females, age: 32.7 years) manipulation of endoscope within the canal was easy facilitating endomeatal incision and elevation of tympanomeatal flap. An optimum exposure of incudo-stapedial joint was obtained in 88.24 % cases. Adequate exposure of crura was obtained in 82.35 % and the footplate in 95 %. The removal of postero-superior bony wall was required in 30 % and chorda tympani mobilization in 25 % of cases. The average operative time was 31 min. Audiometry done at 6 weeks showed, complete air–bone gap closure in 55 %, mild conductive hearing loss (up to 20 dB) in 30 % and mixed hearing loss in 2 cases (BC up to 30 dB and air–bone gap up to 20 dB). In one patient who initially had hearing improvement post operatively, developed moderate conductive hearing loss at 10 weeks. Performing fully endoscopic stapedotomy using a 4 mm nasal endoscope is a feasible option giving excellent visualization with good results. © 2014, Springer-Verlag Berlin Heidelberg.


Patil K.N.,Smt Kashibai Navale Medical College And General Hospital | Singh N.D.,Smt Kashibai Navale Medical College And General Hospital
Journal of Anaesthesiology Clinical Pharmacology | Year: 2015

Background and Aims: Ropivacaine is a new amide, long acting, pure S-enantiomer, local anesthetic, with differential blocking effect. The addition of clonidine to local anesthetic improves the quality of peripheral nerve blocks. This study was conducted to evaluate the effect of clonidine on characteristics of ropivacaine-induced supraclavicular brachial plexus block. Material and Methods: A total of 60 adult patients were randomly recruited to two groups of 30 each: Group I: 30 ml 0.75% ropivacaine + 1 ml normal saline. Group II: 30 ml 0.75% ropivacaine + 1 mcg/kg clonidine diluted to 1 ml with normal saline. Results: The onset of sensorimotor block was earlier in Group II (4.36 ± 0.81 min for sensory block and 9.83 ± 1.12 min for motor block) than in Group I (4.84 ± 0.65 min for sensory block and 10.85 ± 0.79 min for motor block). The duration of both sensory and motor block were significantly prolonged by clonidine (P < 0.001). The duration of analgesia was also prolonged in patients receiving clonidine (613.10 ± 51.797 min vs. 878.33 ± 89.955 min). Although incidence of hypotension and bradycardia was higher in Group II when compared to Group I, it was not clinically significant. Conclusions: Ropivacaine 0.75% is well-tolerated and provides effective surgical anesthesia as well as relief of postoperative pain. Clonidine as an adjuvant to ropivacaine significantly enhances the quality of supraclavicular brachial plexus block by faster onset, prolonged duration of sensory and motor block and improved postoperative analgesia, without associated adverse effects at the dose used.


Shenwai M.R.,Smt Kashibai Navale Medical College And General Hospital | Patil K.B.,Smt Kashibai Navale Medical College And General Hospital
Journal of Clinical and Diagnostic Research | Year: 2013

Background: The traditional viva examination which is still predominantly used in most of the medical institutions as one of the assessment methods has some demerits like lack of standardization, objectivity & reliability. The process involves many faculty members from respective departments. Hence there can be variations in the time allotted to each student, number of questions asked, and difficulty level of the questions. These can be resolved by structuring the oral examination to make it a better assessment tool. The present study was conducted to introduce structured oral examination (SOE) as a novel assessment tool to first year M.B.B.S. students in Physiology and evaluating the process by taking feedback from the students and faculty. Material and Methods: All the subjects [first year M.B.B.S. students (n=100)] were initially assessed by traditional viva. Feedback in the form of a questionnaire was collected from the students. Questionnaire included various questions based on Likert scale and numerical value for each response was decided. Topic for the structured oral examination was decided by the faculty members. Students were intimated about the viva process well in advance. A checklist of questions to be asked in the structured viva was prepared and their probable/most correct answers were discussed with the faculty in advance. Feedback was again collected from the students after the viva session. Statistical analysis of the questionnaire was done using 'paired t-test'. Results: Questionnaire analysis depicted that students were overall satisfied with the structured viva and felt it better than the traditional viva. Statistically significant differences (p=0.0001) were observed in terms of uniformity of questions asked, syllabus coverage, reduction in the anxiety levels etc. between these two assessment methods. Faculty members also expressed that structured oral examinations are better in terms of reducing bias, minimising luck factor and uniformity of questions makes SOE a fair assessment tool. Conclusion: Structured oral examination can be a better assessment tool and with some modifications in blueprinting it will be acceptable to the students as well as faculty.


Nemade S.V.,Smt Kashibai Navale Medical College And General Hospital | Naik C.S.,Smt Kashibai Navale Medical College And General Hospital
Annals of Otology, Rhinology and Laryngology | Year: 2014

Objective: Auricular seroma is a cystic swelling filled with serous fluid. It occurs spontaneously or following trauma. Successful treatment of the seroma remains a challenge because this disease has a high propensity for recurrence. The aim was to study the results of the Plaster of Paris (POP) cast in treatment of seroma in terms of complete resolution of swelling, recurrence, and auricular aesthesis. Study Design: Prospective. Setting: Smt. Kashibai Navale Medical College and General Hospital. Materials and Methods: A total of 48 patients with auricular seroma were studied. They were treated with aspiration of the cyst followed by compression dressing with a POP cast, taking the contour of the pinna. The POP cast was kept for 3 days. The patients were followed up for 6 months for recurrence. Results: Out of 48 patients, 43 patients had complete resolution of the swelling in a single application of the POP cast. Five patients needed 2 applications of the POP cast. Not a single patient had recurrence. Temporary discoloration or thickening of the pinna was noted in 8 patients. No major complications like perichondritis were noted. Conclusion: Aspiration and contour dressing using POP is an innovative and effective treatment for management of auricular seroma as it prevents surgical trauma and recurrence and gives cosmetically excellent results. © 2014 The Author(s).


Gogate B.P.,Smt Kashibai Navale Medical College And General Hospital | Anand M.,Smt Kashibai Navale Medical College And General Hospital | Deshmukh S.D.,Smt Kashibai Navale Medical College And General Hospital | Purandare S.N.,Smt Kashibai Navale Medical College And General Hospital
Journal of Oral and Maxillofacial Pathology | Year: 2013

Malignant peripheral nerve sheath tumor (MPNST) is very uncommon tumor of parotid gland and it is an uncommon spindle cell sarcoma accounting for approximately 5% of all soft-tissue sarcoma. There is strong association between MPNSTs and neurofibromatosis (NF-1) and previous irradiation. Structural abnormality of chromosome 17 is associated with NF-1 and so MPNST. We present a case of a 78-year-old male presenting with slowly growing parotid mass who underwent tumor resection.


Muley V.A.,Smt Kashibai Navale Medical College And General Hospital | Ghadage D.P.,Smt Kashibai Navale Medical College And General Hospital | Bhore A.V.,Smt Kashibai Navale Medical College And General Hospital
Journal of Global Infectious Diseases | Year: 2015

Neonatal septicemia is an important cause of morbidity and mortality. The present study was undertaken to determine the bacteriological profile and antimicrobial susceptibility pattern of prevalent pathogens isolated from the blood of septicemic neonates from Neonatal Intensive Care Unit (NICU). A total of 180 blood samples of septicemic neonates were studied bacteriologically. Antimicrobial susceptibility testing was done by the Kirby Bauer disc diffusion method in accordance to Clinical Laboratory Standards Institutes (CLSI) guidelines. 26.6% (48 out of 180) cases of septicemia could be confirmed by blood culture. Of these, 66.7% cases were of early onset septicemia (EOS) and 33.3% were of late onset septicemia (LOS). Klebsiella pneumoniae was the predominant pathogen (35.4%) among the Gram-negative pathogens and Staphylococcus aureus (22.9%) was the predominant Gram-positive pathogen. 28% of K. pneumoniae and E. coli isolates were extended spectrum beta-lactamase (ESBL) producers. 18.1% of the Staphylococcus isolates were methicillin-resistant S. aureus (MRSA). Multi-drug-resistance pattern was observed with all the isolates. Ciprofloxacin and aminoglycosides were the most effective drugs against Gram-positive and Gram-negative isolates. This study highlights the predominance of Gram-negative organisms in causing neonatal sepsis and emergence of multi-drug-resistant strains in our set up.

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