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Amarapurkar A.D.,TNMC and BYL Nair Hospital
Journal of Association of Physicians of India | Year: 2014

Dieulafoy disease is an uncommon cause of gastrointestinal system bleeding. It is characterised by bleeding from abnormal submucosal arteriole. Endoscopic therapy and surgery are the preferred treatment option for this lesion. Paul Georges Dieulafoy (1839-1911), a professor of pathology in Paris, France, was the first to describe a series of 10 patients who presented with Dieulafoy disease. The advent of endoscopy has drastically changed the process of diagnosing and treating Dieulafoy lesions, with techniques such as endoscopic banding, haemoclips, thermocoagulation, and injections with adrenaline as alternatives to replace surgical management as was described to be a best practice management. © JAPI.


Desai Praseeda S.,TNMC and BYL Nair Hospital | Anuradha D.,Jamia Millia Islamia University | Shastri Jayanthi S.,TNMC and BYL Nair Hospital
Journal of Clinical and Diagnostic Research | Year: 2013

Background: Sexually Transmitted Infections (STIs) have been shown to enhance the transmission of the Human Immunodeficiency Virus (HIV). The Hepatitis B and the Hepatitis C viral infections are highly prevalent among the HIV-infected persons as a result of shared transmission routes. Aim: To determine the seroprevalence of the HIV, Syphilis, HBV and HCV infections and their co-infection rates among Female Sex Workers (FSWs). Settings and Design: 250 blood samples were collected from FSWs from a red light area of Mumbai by using an outreach strategy. Materials and Methods: Their sera were tested for the HIV antibodies as per the strategy II of the NACO guidelines, for syphilis by RPR, for the HCV antibodies and for HBsAg by ELISA. Results: The study group showed (105/250) 42% HIV reactivity, (15/250) 6% RPR reactivity, (20/250) 8% HBsAg positivity, (7/250) 2. 8% HCV reactivity, (11/250) 4. 4% HIV-RPR reactivity, (7/250) 2. 8% HIV-HBV co-infection and (3/250)1. 2% HIV-HCV co-infection. Statistical test which was used: The Chi square test. Conclusion: A high HIV sero-prevalence was found among the FSWs. A high HIV prevalence was found among the RPR reactive FSWs. The relationship between the HIV reactivity and the RPR reactivity was statistically significant. Co-infections with HBV and HCV were detected among the HIV reactive FSWs, but they were not statistically significant.


Valame D.A.,TNMC and BYL Nair Hospital | Nandapurkar P.,Hedgewar Hospital
Otorhinolaryngology Clinics | Year: 2012

All audiological tests are site-of-lesion tests and are used as a part of a test battery. Pure tone audiometry gives estimate of peripheral hearing status. Speech audiometry, acoustic reflex testing and auditory brain stem response differentiate cochlear and retrocochlear sites of lesion. Addition of cervical vestibular evoked myogenic potentials (VEMP) and ocular VEMP to this battery can further differentiate between saccular vs utricular lesions and between lesions of inferior vs superior vestibular nerve. Overall, this battery of tests provides useful insights into the otoneurological diagnosis of vertigo. Few case examples are cited to elucidate the utility of audiovestibular test battery.


Zanwar V.G.,Tnmc And Byl Nair Hospital | Gambhire P.A.,Tnmc And Byl Nair Hospital | Choksey A.S.,Tnmc And Byl Nair Hospital | Rathi P.M.,Tnmc And Byl Nair Hospital
Journal of Association of Physicians of India | Year: 2015

Killian-Jamieson (K-J) diverticulum is an outpouching from the lateral wall of the proximal cervical oesophagus and is less commonly encountered compared to Zenker’s diverticulum (ZD). These diverticulae arise between the fibers of the cricopharyngeus muscle superiorly and longitudinal muscle of the oesophagus inferiorly. In this report we present a case of a symptomatic Killian Jamieson diverticulum and review the clinical presentation, differential diagnosis and radiological findings that distinguish it from the more common Zenker’s diverticulum. © 2015 Journal of Association of Physicians of India. All rights reserved.


Ubale P.,TNMC and BYL Nair Hospital | Mali A.,TNMC and BYL Nair Hospital | Gujjar P.,TNMC and BYL Nair Hospital
Anaesthesia, Pain and Intensive Care | Year: 2014

We report a case of 54 year male, a case of dilated cardiomyopathy with low ejection fraction who underwent Functional Endoscopic Sinus Surgery (FESS) under general anesthesia. Anesthetic management of such patients is always requires the highest level of expertise as they are usually complicated by progressive congestive cardiac failure (CHF). The uneventful course of the anesthesia in the presented case was related to the thorough systemic evaluation and careful anesthetic strategy.


Bothra J.,TNMC and BYL Nair Hospital | Shah H.,TNMC and BYL Nair Hospital | Sandlas G.,TNMC and BYL Nair Hospital | Jayaswal S.,TNMC and BYL Nair Hospital
Journal of Pediatric Surgery Case Reports | Year: 2015

Acquired bronchoesophageal fistula in children is usually a late diagnosis, due to the rarity of the condition. The diagnosis was further complicated by presence of multiple co-morbid conditions. We would like to emphasize the importance of tackling the co-morbid factors strategically along with the surgical aspects in this case report. © 2015 The Authors . Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license.


Deshpande S.D.,Tnmc And Byl Nair Hospital | Kulkarni K.S.,Tnmc And Byl Nair Hospital
Indian Journal of Experimental Biology | Year: 2010

Staphylococcus aureus is the most frequently isolated pathogen from wounds with multiple resistances to antibiotics. Honey has been demonstrated and reported to be effective antibacterial agent on Gram positive and Gram negative organisms. Hence, the present study was conducted to evaluate the in vitro antibacterial effect of Indian honeys on Staphylococcus aureus obtained from wounds. A total of 123 Staphylococcus aureus isolates along with ATCC 25923 were categorized as sensitive, multi drug resistant (MDR) and non-MDR strains. Out of total nine Indian honeys (three each of unifloral, multifloral and branded marketed honey) used, three unifloral and three multifloral honey samples showed antibacterial activity against all the organisms tested by Agar diffusion method but not the branded marketed honeys. The MIC values of all honey samples for all studied Staphylococcus aureus isolates ranged between 5-15% (v/v). Unifloral honey samples showed higher antibacterial activity than multifloral honey. The single sample of Jambhul honey showed the highest activity. Thus, Indian honeys were found to be effective for their antimicrobial activity on sensitive, non-MDR, MDR and ATCC strains of S. aureus.


Adwani S.,TNMC and BYL Nair Hospital | Desai U.D.,TNMC and BYL Nair Hospital | Joshi J.M.,TNMC and BYL Nair Hospital
Journal of Krishna Institute of Medical Sciences University | Year: 2016

Background: India is a high burden country for Tuberculosis (TB). As per the World Health Organization (WHO) statistics, 24000 cases of Multi Drug Resistant (MDR) TB were diagnosed in India in 2014. MDR-TB patients consist of a heterogeneous cohort and management has its challenges. Aims and objectives: We studied the prevalence of Pre-Extensively Drug Resistant TB (Pre XDR-TB) and Extensively Drug Resistant TB (XDR-TB) among patients of pulmonary MDR-TB not previously exposed to second-line anti-tuberculous drugs and having baseline second-line Drug Susceptibility Testing (DST) against Fluoroquinolones (FQ) and Aminoglycosides (AM). Results: We included 227 patients. On the basis of the DST, patients were grouped into- 1) MDR-TB, 2) MDR-TB with FQ resistance {Pre XDR-TB (FQ)}, 3) MDR-TB with AM resistance {Pre XDR-TB (AM)} 4) XDR-TB. Of the 227 patients, 89 (39.2%) had MDR-TB, 127 (55.94%) had Pre XDR-TB (FQ), none had Pre XDR-TB (AM) and 11 (4.86%) had XDR-TB. Nine (4%) patients were human immunodeficiency (HIV) infected and 25(11%) had Diabetes Mellitus (DM). Conclusion: This study highlights the importance of baseline DST to FQ and AM in patients of diagnosed or suspected MDR-TB. We encountered a higher prevalence of Pre XDR-TB (FQ) which of concern in management of MDR-TB. © Journal of Krishna Institute of Medical Sciences University.


PubMed | Tnmc And Byl Nair Hospital
Type: Journal Article | Journal: Indian journal of psychiatry | Year: 2011

The important domains of emotional intelligence (EI) are self-awareness and control of emotions, motivating oneself, and empathy. These are necessary to handle any relationship. This study aims to (i) assess emotional intelligence focusing specifically on empathy; (ii) to study the level of anger; and (iii) correlating level of anger with (a) EI and (b) empathy in medical postgraduates.Subjects were assessed randomly after obtaining informed consent, through semi-structured proforma and various scales, including Emotional Quotient Self-Assessment Checklist, Multi-Dimensional Emotional Empathy Scale, and Clinical Anger Scale. Data was analyzed using multivariate analysis with analysis of covariance test.On Emotional Quotient Self-Assessment checklist, more than 70% had poor emotional intelligence. Married males in the study were more confident and empathizing. Those with some major problem at home were more aware of their own emotions and others feelings. Residents who had voluntarily chosen their specialty postgraduation training course (eg, medicine, surgery, and others), those who had less work load, those who had time for recreational activities, and exercise had scored high on EI. Good control of emotions in self was associated with good relationship with superiors and colleagues. Score on Clinical anger was moderate to severe in 10.6% of the subjects. EI and clinical anger correlated negatively.


PubMed | TNMC and BYL Nair Hospital
Type: Journal Article | Journal: The Indian journal of radiology & imaging | Year: 2017

The typical sonomorphology of homogeneously hypoechoic texture of an enlarged parathyroid gland (PG) is a reflection of uniform arrangement of the parathormone-producing chief cells. A variable cellular arrangement, hemorrhage, fibrosis, and adipocytes cause heterogeneous appearance. We describe a case of a 32-year-old male, a case of tertiary hyperparathyroidism, with increased serum parathormone levels, hypercalcemia, and enlargement of all four PGs, albeit with differing morphology. The left lower gland had two nodules, namely, superior and inferior. The inferior nodule of the left lower gland had an echogenic core surrounded by a sonolucent rim whereas the superior nodule was homogenously hyoechoic. The left upper gland had an echopattern exactly reverse of the inferior nodule of the left lower PG, i.e., hypoechoic gland surrounded by hyperechoic periphery. The appearance of the right-sided glands was that of the superior nodule of the left lower PG. On histopathology, the hypoechoic areas corresponded to numerous chief cells and congested vessels whereas edema gave rise to an increase in echogenicity. This report exemplifies atypical sonographic appearances of PG and their histopathologic correlation.

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