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1.
Indian J Cancer ; 2015 July-Sept; 52(3): 475-478
Article in English | IMSEAR | ID: sea-173982

ABSTRACT

INTRODUCTION: Most of the adrenal masses are discovered incidentally by imaging techniques for reasons unrelated to adrenal diseases. Treatment is based on various factors such as, nature of adrenal mass, age of presentation, size of tumor, and the functional status of tumor. We report a series of 14 consecutive cases of adrenal tumors treated in a single surgical unit in our hospital. AIM: The aim of this study was to evaluate the clinical profile and outcome of treatment of adrenal tumors treated in a surgical unit. MATERIALS AND METHODS: It is a retrospective study data of 14 cases of adrenal tumors treated in a single surgical unit in University Hospital over 10 years have been analyzed. Various parameters such as gender, age, size of tumor, functional status, histopathology, type of management, and outcome have been reviewed. RESULTS: A total of 14 patients with adrenal masses were seen over a 10 year period (1997‑2006). All were referred cases, either from endocrinology or medicine wards. There were seven female and seven male patients. Mean age of patients was 48.6 years (range 14‑60 years). Mean size of tumor was 8.0 cm (5.9 cm for benign tumors and 9.7 cm for malignant tumors). There were six cases of adrenal carcinoma, four cases of adrenal myelolipoma, two cases of pheochromocytoma, and one each case of adrenal hyperplasia and histoplasmosis. There were only two functional tumors. All, except two malignant cases were treated operatively. A total of 5 year survival was 100% in benign cases and 27% in malignant tumors. CONCLUSION: Adrenal tumors need to be assessed for their functional status and malignant potential prior to treatment. Surgical excision is usually curative for benign lesion. Among malignant tumors the benefits of surgery depend on local extent and metastatic status of tumors.

2.
Indian J Med Microbiol ; 2013 Jan-Mar; 31(1): 34-39
Article in English | IMSEAR | ID: sea-147543

ABSTRACT

Background: Diagnosis of invasive aspergillosis (IA) in immunocompromised patients using galactomannan ELISA (GM-ELISA) has shown variable sensitivity and specificity. Objectives: To assess the diagnostic performance of GM-ELISA and analyze the effect of decreasing the cut off value, neutropenia, antifungals and piperacillin-tazobactam (PTZ). Prognostic value using 30 day all-cause mortality was also determined. Materials and Methods: Serum samples from 81 patients categorized into "proven," "probable," and "possible," categories based on revised EORTC/MSG definitions were tested by GM-ELISA. Results: Sensitivity of GM-ELISA in proven, probable and possible cases was 91.7%, 84.6% and 83.3% respectively. At an index cut-off value of 0.5 an increased sensitivity with minimal loss of specificity was observed. Use of antifungals demonstrated a decrease in sensitivity in proven and possible cases whereas it remained unaffected in probable category. Specificity increased from 75% to 100% with a positivity criterion of >2 consecutive samples. Although an increase in specificity was observed in patients not receiving PTZ, it was not statistically significant. Serial GM index values increased significantly in neutropenic patients and were associated with a poor prognosis. Conclusions: GM-ELISA may be a useful diagnostic and prognostic modality for the detection of IA in high risk patients.

3.
Indian Pediatr ; 2009 Sept; 46(9): 794-796
Article in English | IMSEAR | ID: sea-144178

ABSTRACT

We present a retrospective analysis of clinical profile of 100 children admitted to a Government hospital at Delhi between April 2005 and December 2006 with group A meningococcal infection. Maximum children presented in late winter and spring.Younger children were less affected (5% children < 1 year). Fever (86%), vomiting (64%) and rash (63%) were the most common presenting symptoms. All children presented within 5 days of onset of symptoms and 52% within 24 hours. 67 % children had meningococcal meningitis; 20% had meningococcemia; and 13% had both. Overall mortality was 17%. Altered sensorium and shock at presentation significantly increased the mortality. All culture positive cases had group A Neisseria meningitides. All meningococcal isolates were sensitive to penicillin/ampicillin, ciprofloxacin, ceftriaxone, chloramphenicol and erythromycin except, one each resistant to ampicillin and erythromycin.


Subject(s)
Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteremia/drug therapy , Bacteremia/epidemiology , Bacteremia/metabolism , Child , Child, Preschool , Disease Outbreaks , Female , Humans , India/epidemiology , Infant , Male , Meningitis, Meningococcal/drug therapy , Meningitis, Meningococcal/epidemiology , Meningitis, Meningococcal/metabolism , Neisseria meningitidis, Serogroup A/drug effects , Neisseria meningitidis, Serogroup A/isolation & purification , Retrospective Studies
4.
Indian J Cancer ; 2009 Jan-Mar; 46(1): 34-9
Article in English | IMSEAR | ID: sea-49867

ABSTRACT

BACKGROUND: Desmoids are infiltrative, locally destructive, soft tissue tumors. Although they do not metastasize, the incidence of local recurrence is quite high. AIM: Present study aimed at reporting the 10-year experience of 32 desmoid cases and reviewing some facts with symptoms, investigation, and treatment of the disease. MATERIALS AND METHODS: Thirty two cases of desmoid tumors were reviewed over a 10-year span. Surgical resection and adjuvant radiotherapy were the treatments of choice whenever histological margins were positive. RESULTS: Multiparous women in reproductive age were the most commonly afflicted. The commonest site of presentation was the abdominal wall. Ninety one percent (20/22) were infraumbilical. The tumors were found in the rectus sheath in 14 patients (64%) and were laterally situated in 8 patients (36%). Local infiltration was found in six patients and the urinary bladder was most commonly involved (3/6). Locally recurrent desmoids were seen in eight patients (25%). CONCLUSIONS: In our experience, 25% of the desmoid tumors (8/32) were recurrent and postoperative radiotherapy did not seem to influence the local recurrence rate. The most important predictor for recurrence was tumors of > 5 cm.

6.
Indian J Physiol Pharmacol ; 2008 Jul-Sept; 52(3): 283-287
Article in English | IMSEAR | ID: sea-145879

ABSTRACT

There is growing evidence that oxidative stress contributes to the pathogenesis of hypertension. Our aim was to measure oxidative stress in hypertensive subjects, and assess the potential confounding influences of antihypertensive therapy. Serum malondialdehyde and antioxidant levels were estimated in patients at the time of presentation and also after a antihypertensive therapy for 3 months. During the period of study no antioxidant/s was given to the patients and control subjects. Mean blood pressure values were altered in the hypertensive patients following antihypertensive therapy from their respective values observed at the time of presentation. Serum malondialdehyde levels were significantly higher in the hypertensive patients in comparison to control cases. The antioxidant activity of enzymes super oxide dismutase, glutathione and non enzymatic antioxidant levels of vitamins E and C were significantly lower in patients compared to controls. After 3 months of antihypertensive treatment all the above parameters showed reversal in the respective levels of serum malondialdehyde and antioxidant activity. Antihypertensive medications lower the blood pressure and thereby results in reduced oxidative stress which indicates that oxidative stress is not the cause, but rather a consequence, of hypertension.

9.
Article in English | IMSEAR | ID: sea-46280

ABSTRACT

OBJECTIVE: To measure the lipid peroxidation and endogenous antioxidant enzyme status in oral carcinoma and the protective role of exogenous antioxidants. MATERIAL AND METHODS: 20 new cases of histologically proven oral squamous cell carcinoma, 20 of leukoplakia and 20 age and sex matched healthy conrols were included. Intra oral pH of patients and controlled were measured by quantitative litmus paper test and serum was analysed for malonialdehyde (MDA), super oxide bismutase (SOD), catalase and glutathione peroxidase (GP). Patients with leukoplakia were treated with exogenous antioxidants for 3 months and the same were reassessed. RESULTS: Oral pH of oral cancer patients was neutral (PH-7) but that of leukoplakia and controls were mildly acidic (6.64 and 6.58 respectively). Serum malonialdehyde levels were highest in oral cancer group. With antioxidant enzymes super oxide bismutase, catalase and glutathione peroxidase different pattern was noticed. Antioxidant enzymes remained almost the same (P > 0.005 each) in patients with leukoplakia after 3 months of vitamin A,C and E. but there was marginal increase in catalase level (P<0.05). CONCLUSION: This study shows the positive benefit of vitamin (A,C,E) and nutrition supplementation on the antioxidant enzyme defense system hence prevention of oral carcinogenesis in patients with leukoplakia.


Subject(s)
Antioxidants/metabolism , Carcinoma, Squamous Cell/enzymology , Catalase/metabolism , Glutathione Peroxidase/metabolism , Humans , Leukoplakia/enzymology , Lipid Peroxidation , Malondialdehyde/metabolism , Mouth Neoplasms/enzymology , Oxidoreductases/metabolism , Precancerous Conditions/enzymology , Superoxide Dismutase/metabolism
10.
Article in English | IMSEAR | ID: sea-171251

ABSTRACT

To compare the effectiveness of clomiphene citrate used alone and in combination with ethinyl estradiol on endometrial receptivity in infertile women with polycystic ovaries (PCO). Color doppler ultrasonographic evaluation of endometrial thickness (ET) and pulsatility index (PI) was done for 27 infertile women with polycystic ovaries. These women were studied for one control unmedicated cycle and randomized to receive clomiphene citrate (CC) alone and CC with ethinyl estradiol (EE) in subsequent 2 cycles. The total duration of follow up of patients was 77 months in which 2 women conceived in control cycle and 1 conceived in CC+ EE cycle. On day of HCGinjection, mean ET was 6.96 + 1.63mmin control cycle, 7.25 + 1.64mmin CC and 8.53 + 1.36mmin CC + EE cycle, whereas, the mean pulsatility index (PI) of dominant uterine arteries was 4.09 + 0.97 in control cycle, 3.96 + 0.95 in CC cycle and 3.75 + 0.98 in CC + EE cycle. On day of HCG injection, mean PI of non-dominant uterine arteries was 4.06 + 1.01 in control, 4.00 + 1.02 in CC and 3.71 + 0.95 in CC + EE cycles. A statistically significant change (p< 0.05) was observed in ET and PI of dominant and non-dominant uterine arteries in control and CC+ EE cycle and those in CC and CC+ EE cycles. Addition of ethinyl estradiol to clomiphene induced cycles produces a favorable endometrial response in infertile women with PCO.

11.
J Indian Soc Pedod Prev Dent ; 2004 Oct-Dec; 22(4): 172-4
Article in English | IMSEAR | ID: sea-114553

ABSTRACT

In the field of radiodiagnosis shadows often raise doubts. On these depend the invasive investigative procedures which lead to the final diagnosis. The radiologist's word is often considered as the last word in labeling a lesion. The treatment protocol which follows makes a world of a difference to the patient. We report interesting cases where the patients were radiographed prior to orthodontic treatment and coincidentally we found-un believable hidden treasure! This is a modest attempt to emphasize that each shadow in a radiograph should be scrutinized. Needless to say, the keen observation and experience of the diagnostician is of penultimate importance in deciphering the abnormal from the normal.

13.
J Indian Med Assoc ; 2003 Oct; 101(10): 586-7, 596
Article in English | IMSEAR | ID: sea-99621

ABSTRACT

Twelve cases of xanthogranulomatous cholecystitis are reported. The clinical presentation was similar to chronic cholecystitis. All patients had associated gallstones. The diagnosis was achieved at histopathological examination of the resected gall bladders and none had any focus of malignancy. Cholecystectomy was curative.


Subject(s)
Adult , Aged , Cholecystitis/complications , Female , Gallstones/complications , Granuloma/complications , Humans , Male , Middle Aged , Retrospective Studies , Xanthomatosis/complications
14.
Ann Card Anaesth ; 2003 Jul; 6(2): 136-42
Article in English | IMSEAR | ID: sea-1444

ABSTRACT

Blood conservation is an important aspect of care provided to the patients undergoing cardiac operations with cardiopulmonary bypass (CPB). It is even more important in patients with anticipated prolonged CPB, redo cardiac surgery, patients having negative blood group and in patients undergoing emergency cardiac surgery. In prolonged CPB the blood is subjected to more destruction of important coagulation factors, in redo surgery the separation of adhesions leads to increased bleeding and difficulty in achieving the haemostasis and in patients with negative blood group and emergency operations, the availability of sufficient blood can be a problem. Harvesting the autologous platelet rich plasma (PRP) can be a useful method of blood conservation in these patients. The above four categories of patients were prospectively studied, using either autologous whole blood donation or autologous platelet rich plasma (PRP) harvest in the immediate pre-bypass period. Forty two patients were included in the study and randomly divided into two equal groups of 21 each, control group (Group I) in which one unit of whole blood was withdrawn, and PRP group (Group II) where autologous plateletpheresis was utilised. After reversal of heparin, autologous whole blood was transfused in the control group and autologous PRP was transfused in the PRP group. The chest tube drainage and the requirement of homologous blood and blood products were recorded. Average PRP harvest was 643.33 +/- 133.51 mL in PRP group and the mean whole blood donation was 333.75 +/- 79.58 mL in the control group. Demographic, preoperative and intra operative data showed no statistically significant differences between the two groups. The PRP group patients drained 26.44% less (p<0.001) and required 38.5% less homologous blood and blood products (p<0.05), in the postoperative period. Haemoglobin levels on day zero (day of operation) and day three were statistically not different between the two groups. We conclude that autologous plateletpheresis is a better method of blood conservation in terms of better haemostasis, and less requirement of blood and blood products in the postoperative period as compared with the autologous whole blood donation. This technique can be especially useful in the above-mentioned categories of patients.

15.
Article in English | IMSEAR | ID: sea-124321

ABSTRACT

The commonest causes of acute pancreatitis are cholelithiasis and alcohol. Rare causes include various viral infections, among which mumps is the commonest. Hepatitis A, hepatitis B and, recently, hepatitis E have been reported to cause acute but mild pancreatitis in patients with acute viral hepatitis. This report describes a case of severe acute pancreatitis caused by hepatitis A.


Subject(s)
Acute Disease , Adolescent , Diagnosis, Differential , Hepatitis A/complications , Humans , Male , Pancreatitis/diagnosis
17.
Neurol India ; 2002 Mar; 50(1): 94-6
Article in English | IMSEAR | ID: sea-121395

ABSTRACT

A case of limb hypertrophy secondary to syringomyelia is presented.


Subject(s)
Arm/pathology , Humans , Hypertrophy , Male , Middle Aged , Syringomyelia/pathology
18.
Indian J Med Sci ; 2001 May; 55(5): 253-6
Article in English | IMSEAR | ID: sea-68084

ABSTRACT

Multiple drug resistance is exhibited by coagulase positive staphylococcus aureus isolated from hospitals. Prevalence of MRSA due to prolonged stay in the hospital, instrumentation/invasive procedure, surgical intervention and misuse of antibiotics have been reported. Antibiogram of 200 coagulase staphylococci showed 10% MRSA strains. Predominant phage type 81 belonged to unclassified group followed by phage type 84 belonged to group 3. As the management of MRSA is not easy, efforts should be made to eradicate the MRSA by taking strict aseptic conditions and the severe infections should be treated according to the sensitivity pattern of the strain.


Subject(s)
Animals , Anti-Bacterial Agents/pharmacology , Bacteriophage Typing , Coagulase/biosynthesis , Humans , India/epidemiology , Methicillin Resistance , Microbial Sensitivity Tests , Prevalence , Staphylococcus aureus/drug effects , beta-Lactamases/biosynthesis
19.
Article in English | IMSEAR | ID: sea-63561

ABSTRACT

We report a 55-year-old man with recurrent bleeding from the small intestine. Preoperative investigations suggested it to be a small intestine tumor. The resected specimen was diagnosed at histology as dermatofibrosarcoma protuberans of the small bowel.


Subject(s)
Biopsy, Needle , Dermatofibrosarcoma/diagnosis , Digestive System Surgical Procedures/methods , Endoscopy, Gastrointestinal , Follow-Up Studies , Humans , Jejunal Neoplasms/diagnosis , Laparotomy , Male , Middle Aged , Treatment Outcome
20.
Article in English | IMSEAR | ID: sea-93066

ABSTRACT

OBJECTIVES: Hypofunctioning benign cystic thyroid nodules are a common occurrence in iodine deficient region. There are reports of resolution of recurrent thyroid cysts with tetracycline instillation. Hence we conducted a study in 20 patients with hypofunctioning benign cystic thyroid nodules to document response to intracystic instillation of tetracycline as a primary modality of treatment. METHODS: Twenty patients were thoroughly investigated for the presence of malignancy clinically, radiologically and cytologically. One milliliter of tetracycline was instilled under ultrasonographic guidance. Response to therapy was assessed clinically and ultrasonographically at one, three, six and 12 months. RESULTS: Study group comprised of five male and 15 female patients with mean age 30 +/- 8 years. Initial mean volume of nodules was 15 +/- 7 ml (6 to 27 ml), which was decreased to 3 +/- 3 ml at one month, 2 +/- 3 ml at three months, and 1 +/- 2 ml at six months. Maximum number of patients (75%) responded within three months, however two patients required reaspiration and reinstallation of tetracycline. Ultrasonography revealed fibrotic scar as thick wall with internal echodensities in six patients (30%) six month after sclerotherapy. There was high rate of patient satisfaction, as cosmetically tetracycline did not leave any scar, which was unavoidable with surgery. Six patients (30%) reported mild pain after injection, and one patient developed redness at the site of injection. CONCLUSIONS: Intracystic tetracycline sclerotherapy is highly effective as primary mode of treatment in hypofunctioning benign cystic thyroid nodule in selected group of patients not at high risk of malignancy.


Subject(s)
Adult , Female , Humans , India , Injections, Intralesional , Male , Middle Aged , Sclerosing Solutions/administration & dosage , Sclerotherapy/methods , Tetracycline/administration & dosage , Time Factors , Treatment Outcome
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