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Lynch D.,National Jewish Health | Chawla A.,Sri Aurobindo Institute of Medical science | Garg K.,Aurora University | Tammemagi M.C.,Brock University | And 3 more authors.
Radiology | Year: 2013

Purpose: To determine the prevalence of interstitial lung abnormalities (ILAs) at initial computed tomography (CT) examination and the rate of progression of ILAs on 2-year follow-up CT images in a National Lung Screening Trial population studied at a single site. Materials and Methods: The study was approved by the institutional review board and informed consent was obtained from all participants. Image review for this study was HIPAA compliant. We reviewed the CT images of 884 cigarette smokers who underwent low-dose CT at a single site in the National Lung Screening Trial. CT findings were categorized as having no evidence of ILA, equivocal for ILA, or ILA. We categorized the type of ILA as nonfibrotic (ground-glass opacity, consolidation, mosaic attenuation), or fibrotic (ground glass with reticular pattern, reticular pattern, honeycombing). We evaluated the temporal change of the CT findings (no change, improvement, or progression) of ILA at 2-year follow-up. A x2 with Fisher exact test or unpaired t test was used to determine whether smoking parameters were associated with progression of ILA at 2-year follow-up CT. Results: The prevalence of ILA was 9.7% (86 of 884 participants; 95% confidence interval: 7.9%, 11.9%), with a further 11.5% (102 of 884 participants) who had findings equivocal for ILA. The pattern was fibrotic in 19 (2.1%), nonfibrotic in 52 (5.9%), and mixed fibrotic and nonfibrotic in 15 (1.7%) of the 86 participants with ILA. The percentage of current smokers (P = .001) and mean number of cigarette pack-years (P = .001) were significantly higher in those with ILA than those without. At 2-year follow-up of those with ILA (n = 79), findings of nonfibrotic ILA improved in 49% of cases and progressed in 11%. Fibrotic ILA improved in 0% and progressed in 37% of cases. Conclusion: ILA is common in cigarette smokers. Nonfibrotic ILA improved in about 50% of cases, and fibrotic ILA progressed in about 37%. © 2013 RSNA.


Jain N.,Sri Aurobindo Institute of Medical science
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2015

Acute kidney injury (AKI) is an important cause of morbidity and mortality in severe acute pancreatitis (SAP). We aimed in our study to explore the risk factors of AKI in patients with SAP and assess the prognosis of patients with SAP and AKI. This is a retrospective study consisting of analysis of outcome and complications encountered in 72 severe acute pancreatitis patients admitted to a tertiary care center at Indore, India, from May 2011 to April 2012. We encountered 14 AKI cases in the SAP study patients. There was a significant association of diabetes and alcohol with AKI in patients with SAP. Alcohol was found to be an independent significant risk factor for AKI in SAP. All the eight patients with SAP who expired had AKI. None of the patients of SAP without AKI expired during the study. We conclude that the patients with SAP with AKI have a greater mortality rate as compared with the SAP patients without AKI.


Weight transmitted from the fifth lumbar vertebrae to the sacrum is distributed as three separate components between (a) the vertebral bodies anteriorly, (b) the transverse elements intermediately, and (c) the lumbosacral facet joints, posteriorly. The posterior components of the fifth lumbar vertebra share greater proportion of load in comparison with the posterior elements of the upper lumbar vertebral levels. This study focuses on rudimentary lumbosacral facet articulations and their possible effects on load sharing at this region. Twenty sacra bearing rudimentary articulations were collected for analysis. Sixteen of these sacra presented unilateral rudimentary facets, and the remaining four had facets that were bilaterally rudimentary. Thirteen of the sacra with unilateral rudimentary facets showed an accessory articulating area on the upper surface of the ala on the same side as the rudimentary zygapophyseal facet. The remaining three sacra (out of the 16) showed evidence of strong ligamentous attachments between the L5 and S1 transverse elements on the sides of the rudimentary facets. All the sacra with bilateral rudimentary facets demonstrated bilateral accessory L5-S1 articulations. These observations indicated that load transmission at lumbosacral junctions bearing a rudimentary facet joint is not normal and that their associations with strong L5-S1 lumbosacral ligamentous attachments or accessory articulations at the transverse elements serve a compensatory mechanism for load sharing. © 2010 Wiley-Liss, Inc.


Mahato N.K.,Sri Aurobindo Institute of Medical science
Neurosurgical Focus | Year: 2010

Object: Although the area at the auricular surface defines the magnitude of weight transmission to the hip bones, this study proposes that the position of the auricular surfaces may also significantly influence load bearing patterns at the sacrum. This study attempts to investigate and classify variable positions of the auricular surfaces that may cause vertical shifts in weight-bearing patterns between the L-5 and S-1 segments, altering weight distribution at the lumbosacral and sacroiliac regions. Methods: Three hundred human sacra were studied to determine the position and extent of their auricular surfaces in relation to the sacral segments. Specimens were grouped as "normal," "high-up," and "low-down" auricular surface-bearing sacra. All bones were also scrutinized for the presence of accessory articulating facets on the ala of the sacrum and sacralization of the L-5 segment or lumbarization of the S-1 segment. Seven dimensions and 5 articular areas were measured in all sacra. Nine indices were calculated to show proportional representation of dimensions and areas in the bones. Obtained data were analyzed for differences in groups of sacra bearing different auricular surface positions. Results: Thirty-nine of the sacra (13%) showed auricular surfaces that occupied a high-up position (from upper S-1 to low S-2 segments). Forty-four of the sacra (15%) exhibited a low-down auricular surface (from the low S-1 to low S-3 sacral segments). The remaining bones demonstrated a normal position of the surface (from the S-1 to the middle of the S-3 segments). Twenty of the high-up sacra demonstrated unilateral or bilateral accessory articulating facets on the alae that articulated with extended transverse processes of the L-5 vertebrae. The low-down sacra transmitted load predominantly via lower (S2-3) segments and exhibited stouter, broader, and efficient weight-bearing lower sacral elements, and a prominent gap between the S-1 segment and the rest of the sacrum. The high-up sacra: 1) were shorter and broader in comparison with the normal sacra; 2) at times presented accessory articular facets on their alae; 3) had a smaller body span and a wider ala; 4) were found to have the plane of the facet joints nearer to the posterior aspect of the S-1 body; and 5) had the smallest of the facet areas. The low-down sacra were longer than they were broad, had a substantially broad body span at S-1, possessed the smallest interauricular distance, and showed considerable depth of the plane of the facet joints. Conclusions: The position of the auricular surface varies in human sacra. These variations are associated with differential load bearing at the sacral joints. Only the high-up sacra demonstrated the presence of accessory articulating facets between L-5 and S-1. The position of the auricular surface can explain or possibly predict low-back pain situations.


Khandelwal S.,Sri Aurobindo Institute of Medical science
Journal of Clinical and Diagnostic Research | Year: 2013

High - voltage electric burns are very rare in children. This is a report of a seven years old boy, who presented 20 days after severe burns following a contact with a high - voltage electric line during playing. He was treated for the above at another hospital and was referred for further management. His clinical examination revealed; exposed skull bones, a raw area over the right side of the chest wall and a raw area over the right upper limb, which completely exposed the distal radius and the ulnar bones. After properly explaining the purpose of the operation to his parents and getting their consent, the exposed skull bones were covered with multiple pedicle scalp flaps. A bipedicle abdominal flap was used to cover the exposed right forearm bones and a skin grafting was also provided to the chest wall wound at the same time. The abdominal flap was detached safely after three weeks. He withstood the above operations well and was discharged six weeks after the above operations. The bipedicle abdominal flap helped in saving his right forearm and hand and the reason for the publication of this case is its rarity in children.


Bhandari V.,Sri Aurobindo Institute of Medical science | Jain R.K.,Sri Aurobindo Institute of Medical science
Journal of Cancer Research and Therapeutics | Year: 2013

The incidence of bone metastasis in head and neck Squamous cell carcinoma is very uncommon. Aim: This retrospective study was done to identify the frequency, clinical presentation, and the clinical course of the metastatic disease to bone from head and neck primary. Material and Methods: Out of 624 patients of head and neck cancers seen in our clinic 6 patients developed metastasis to solitary or multiple bones during the course of the disease. Results: Postoperative patients had multiple bone involvement whereas others had solitary bone involvement. Main bones involved were parietal bone of skull, shaft of humerus and femur, sacrum, and ribs. All the patients had survival of few months only after developing metastasis. Conclusion: Improvement in technology has resulted in improved results in advanced head and neck cancer patients; hence measures should be taken for complete responders to diagnose this metastasis early and treat them appropriately.


Thatte S.,Sri Aurobindo Institute of Medical science
Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH | Year: 2011

Corneal vascularization develops as a result of various corneal diseases. Fine- needle diathermy (FND) is one of the methods to occlude corneal vessels. To evaluate the efficacy and safety of this method in a series of patients with corneal vascularization. Twenty eight patients with corneal vascularization were treated with FND. The patients were divided into four groups according to etiological factors like pre-keratoplasty (high risk patients), increased keratopathy, recurrent inflammation and postkeratoplasty rejection .The FND was performed under local anaesthesia with the help of a corneal needle of 10-0 monofilament nylon suture. The success of treatment was evaluated in terms of regression and occlusion of corneal vessels. The main aim of a complete occlusion of blood vessels was achieved in all patients. The most frequent complication seen was a transient whitening of the cornea especially around the needle entry in nine cases, which cleared within 24 hours. FND is a simple safe, inexpensive and effective treatment. It can be repeated and used as an alternative therapy for corneal vascularization. © NEPjOPH.


Bhandari V.,Sri Aurobindo Institute of Medical science
Indian Journal of Medical and Paediatric Oncology | Year: 2016

Introduction: Head and neck cancer is a leading health problem in India due to the habit of chewing tobacco and bad oral and dental hygiene. Carcinoma buccal mucosa is more common and is 2.5% of all malignancies at our center. Most of the patients present in stage III and IV and the survival in these cases is not very good. Bone metastasis in advanced cases of carcinoma buccal mucosa is rarely reported in the world literature. Materials and Methods: We present here cases developing bone metastasis in carcinoma buccal mucosa in last 5 years. These patients were young with loco-regionally advanced disease where bone metastasis developed within 1-year of definitive treatment. Results: The flat bones and vertebrae were mainly involved and the survival was also short after diagnosis of metastasis despite the treatment with local Radiotherapy and chemotherapy. Conclusion: The exact cause of metastasis cannot be proved, but the probability of subclinical seedling of malignant cells before the eradication of the primary tumor should be considered along with advanced local and nodal disease with high grade of tumor. © 2016 Indian Journal of Medical and Paediatric Oncology.


Mahato N.K.,Sri Aurobindo Institute of Medical science
Neurosurgical focus | Year: 2010

OBJECT: Although the area at the auricular surface defines the magnitude of weight transmission to the hip bones, this study proposes that the position of the auricular surfaces may also significantly influence load bearing patterns at the sacrum. This study attempts to investigate and classify variable positions of the auricular surfaces that may cause vertical shifts in weight-bearing patterns between the L-5 and S-1 segments, altering weight distribution at the lumbosacral and sacroiliac regions. METHODS: Three hundred human sacra were studied to determine the position and extent of their auricular surfaces in relation to the sacral segments. Specimens were grouped as "normal," "high-up," and "low-down" auricular surface-bearing sacra. All bones were also scrutinized for the presence of accessory articulating facets on the ala of the sacrum and sacralization of the L-5 segment or lumbarization of the S-1 segment. Seven dimensions and 5 articular areas were measured in all sacra. Nine indices were calculated to show proportional representation of dimensions and areas in the bones. Obtained data were analyzed for differences in groups of sacra bearing different auricular surface positions. RESULTS: Thirty-nine of the sacra (13%) showed auricular surfaces that occupied a high-up position (from upper S-1 to low S-2 segments). Forty-four of the sacra (15%) exhibited a low-down auricular surface (from the low S-1 to low S-3 sacral segments). The remaining bones demonstrated a normal position of the surface (from the S-1 to the middle of the S-3 segments). Twenty of the high-up sacra demonstrated unilateral or bilateral accessory articulating facets on the alae that articulated with extended transverse processes of the L-5 vertebrae. The low-down sacra transmitted load predominantly via lower (S2-3) segments and exhibited stouter, broader, and efficient weight-bearing lower sacral elements, and a prominent gap between the S-1 segment and the rest of the sacrum. The high-up sacra: 1) were shorter and broader in comparison with the normal sacra; 2) at times presented accessory articular facets on their alae; 3) had a smaller body span and a wider ala; 4) were found to have the plane of the facet joints nearer to the posterior aspect of the S-1 body; and 5) had the smallest of the facet areas. The low-down sacra were longer than they were broad, had a substantially broad body span at S-1, possessed the smallest interauricular distance, and showed considerable depth of the plane of the facet joints. CONCLUSIONS: The position of the auricular surface varies in human sacra. These variations are associated with differential load bearing at the sacral joints. Only the high-up sacra demonstrated the presence of accessory articulating facets between L-5 and S-1. The position of the auricular surface can explain or possibly predict low-back pain situations.


Bhandari V.,Sri Aurobindo Institute of Medical science
Journal of Cancer Research and Therapeutics | Year: 2014

Introduction: The treatment of choice in cancer esophagus is controversial. Radiation therapy oncology group, Eastern cooperative oncology group and Cochrane studies have shown superiority of concurrent chemoradiation in inoperable carcinoma esophagus. In these studies full dose cisplatin was given every 3 weeks along with radiotherapy and hence had some toxicity. So, we started treating inoperable carcinoma esophagus patients with low dose weekly cisplatin given concurrently with radiotherapy aiming at low toxicity and similar results. Materials and Methods: A total of 31 cases of inoperable cases of carcinoma esophagus were treated with once weekly cisplatin 30 mg/m 2 along with radiotherapy 60 Gy in 30 fractions in 6 weeks on Telecobalt/Linear accelerator. Results: we could achieve lower toxicity with 80%, 35% and 19% with 1, 2, and 3 year's survival with a median survival of 18 months. So, we conclude that this regimen is better than 3 weekly chemotherapy regimen as is better tolerated with less toxicity and similar outcome.

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