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Kumar A.,Vardhaman Mahavir Medical College and Safdarjang Hospital | Lodha R.,All India Institute of Medical Sciences | Kumar P.,All India Institute of Medical Sciences | Kabra S.K.,All India Institute of Medical Sciences
Indian Pediatrics | Year: 2015

Objective: To describe clinical profile, etiology and outcome in children with non-cystic fibrosis bronchiectasis.Methods: A chart review of children diagnosed with non-cystic fibrosis bronchiectasis, attending pediatric chest clinic of tertiary care hospital.Results: The underlying cause was identified in 51 (63.8%) out of 80 children (mean age, 9.6 y). Common causes were post-infectious in 19 (23.8%), suspected primary ciliary dyskinesia in 12 (15%), and allergic bronchopulmonary aspergillosis in 6 (7.5%). One or more complications were observed in 76 (95%) patients; 14 (17.5%) children required surgery and 5 (11.1%) children died.Conclusions: Common causes of non-cystic fibrosis bronchiectasis are post infectious and primary ciliary dyskinesia. There is a need to create awareness about early diagnosis of bronchiectasis as it is often delayed. © 2015, Indian Academy of Pediatrics. Source


Saigal D.,GB Pant Hospital | Wason R.,Vardhaman Mahavir Medical College and Safdarjang Hospital
Indian Journal of Anaesthesia | Year: 2013

Background: Although different techniques have been developed for administering combined spinal epidural (CSE) anaesthesia, none can be described as an ideal one. Objectives: We performed a study to compare two popular CSE techniques: Double segment technique (DST) and single segment (needle through needle) technique (SST) with another alternative technique: Paramedian epidural and midline spinal in the same intervertebral space (single space dual needle technique: SDT). Methods: After institutional ethical clearance, 90 consenting patients undergoing elective lower limb orthopaedic surgery were allocated to receive CSE into one of the three groups (n=30 each): Group I: SST, Group II: SDT, Group III: DST using computerized randomization. The time for technique performance, surgical readiness, technical aspects of epidural and subarachnoid block (SAB) and morbidity were compared. Results: SDT is comparable with SST and DST in time for technique performance (13.42±2.848 min, 12.18±6.092 min, 11.63±3.243 min respectively; P=0.268), time to surgical readiness (18.28±3.624 min, 17.64±5.877 min, 16.87±3.137 min respectively; P=0.42) and incidence of technically perfect block (70%, 66.66%, 76.66%; respectively P=0.757). Use of paramedian route for epidural catheterization in SDT group decreases complications and facilitates catheter insertion. There was a significant number of cases with lack of dural puncture appreciation (SST=ten, none in SDT and DST; P=0.001) and delayed cerebrospinal fluid reflux (SST=five, none in SDT and DST; P=0.005) while performance of SAB in SST group. The incidence of nausea, vomiting, post-operative backache and headache was comparable between the three groups. Conclusion: SDT is an acceptable alternative to DST and SST. Source


Chatterjee B.,Vardhaman Mahavir Medical College and Safdarjang Hospital | Suri J.,Vardhaman Mahavir Medical College and Safdarjang Hospital | Suri J.C.,Vardhaman Mahavir Medical College and Safdarjang Hospital | Mittal P.,Vardhaman Mahavir Medical College and Safdarjang Hospital | Adhikari T.,Vardhaman Mahavir Medical College and Safdarjang Hospital
Sleep Medicine | Year: 2014

Background: Polycystic ovary syndrome (PCOS) is the most common endocrinological disorder among women in the reproductive age group. These women are prone to develop sleep-disordered breathing (SDB) and metabolic disorders. SDB is also associated with metabolic dysfunctions. We hypothesized that SDB is an independent risk factor contributing to metabolic dysfunctions in women with PCOS. Methods: Prospective cross-sectional study in which 50 women with PCOS and not on any treatment were selected. They were divided into two groups: Group 1 - PCOS with SDB and Group 2 - PCOS without SDB. Results: Thirty-three (66%) women with PCOS had SDB. Women in Group 1 had significantly higher systolic blood pressure (SBP) (P = 0.002); diastolic blood pressure (DBP) (P = 0.044); fasting blood sugar (P = 0.006), triglyceride levels (P = 0.014) and mean Ferriman-Gallwey score (P = 0.028). The HDL was significantly lower in group 1 (P = 0.006). In group 1, 42.4% of women had metabolic syndrome (P < 0.001). Excessive daytime sleepiness (EDS) was significantly higher in Group 1 (P = 0.04). Respiratory distress index significantly correlated positively with waist circumference (r = 0.551, P < 0.001), SBP (r = 0.455, P = 0.001), DBP (r = 0.387, P = 0.006), FBS (r = 0.524, P = 0.000), homeostatic model assessment (r = 0.512, P = 0.000), triglycerides (r = 0.384, P = 0.006), free testosterone (r = 0.390, P = 0.005), and negatively with HDL (r = -0.555, P < 0.001). Conclusion: Women with PCOS and SDB had significantly increased metabolic abnormalities as well as more severe hyperandrogenism. Women with PCOS who have metabolic abnormalities or severe hyperandrogenism should undergo an overnight PSG. © 2014 Elsevier B.V. Source


Gandhi S.,Vardhaman Mahavir Medical College and Safdarjang Hospital | Sharma M.,Vardhaman Mahavir Medical College and Safdarjang Hospital | Pakhiddey R.,Vardhaman Mahavir Medical College and Safdarjang Hospital | Thakur A.,Vardhaman Mahavir Medical College and Safdarjang Hospital | And 3 more authors.
Anatomy and Cell Biology | Year: 2015

Anatomical variations of pancreatic head and uncinate process are rarely encountered in clinical practice. These variations are primarily attributed to the complex development of the pancreas. An unduly enlarged uncinate process of the pancreas overlapping the third part of duodenum was discovered during dissection. This malformation of the pancreatic uncinate process was considered to be due to excessive fusion between the ventral and dorsal buds during embryonic development. On further dissection, an avascular pancreatico-duodenal fold guarding the pancreatico-duodenal recess was observed. The enlarged uncinate process can cause compression of neurovascular structures and also cause compression of adjoining viscera. The pancreatico-duodenal recess becomes a potential site for internal herniation. This case is of particular interest to the gastroenterologists and surgeons performing surgical resections. Precise knowledge of embryogenesis of such pancreatic anomalies is necessary for understanding and thus treating many diseases of the pancreas. © 2015. Source

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