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Dhawan A, Bisherwal K, Arora VK, Gandhi V. Incontinentia pigmenti in a male neonate: An Indian perspective. INDIAN JOURNAL OF PAEDIATRIC DERMATOLOGY 2015. [DOI: 10.4103/2319-7250.165617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Parihar A, Tickoo SK, Kumar S, Arora VK. Xp11 Translocation Renal Cell Carcinoma Morphologically Mimicking Clear Cell–Papillary Renal Cell Carcinoma in an Adult Patient. Int J Surg Pathol 2014; 23:234-7. [DOI: 10.1177/1066896914562280] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Xp11 translocation renal cell carcinoma (RCC) is a relatively rare tumor mainly affecting children and adolescents. It shows significant morphological overlap with the 2 most common adult renal tumors, which are the clear cell (conventional) RCC and papillary RCC. We describe case of a young adult female who presented with right flank pain and abdominal mass. Radiological investigations showed features suggestive of renal cell carcinoma in the right kidney. Histopathological findings while suggestive of Xp11 carcinoma, showed significant overlap with the recently described entity clear cell papillary RCC. TFE3 immunohistochemistry confirmed the tumor to be Xp11 translocation RCC. The patient had an aggressive course with lymph node metastasis. In this report, we discuss differential diagnosis and the diagnostic challenges of Xp11 translocation RCC in adults.
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Gami N, Mundhra R, Guleria K, Arora VK, Garg S. Recurrent pyometra and xanthogranulomatous salpingitis: A rare pathologic association in a postmenopausal lady. J Midlife Health 2014; 5:156-8. [PMID: 25317003 PMCID: PMC4195190 DOI: 10.4103/0976-7800.141227] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Xanthogranulomatous inflammation is a rare, non-neoplastic variant of chronic inflammation. Of the 15 reported cases of Xanthogranulomatous endometritis, majority (60%) were accompanied by endometrial carcinoma. We herein report a case of a postmenopausal woman presenting with recurrent pyometra who was suspected to be case of cervical tuberculosis and treated for the same. Inspite of antitubercular therapy, she had cervical stenosis and developed recurrent pyometra over the next 2 years requiring repeated drainage. She then underwent hysterectomy and was found to have co-existent Xanthogranulomatous salpingitis (XGS) on histopathological examination. Xanthogranulomatous inflammation is a rare pathological diagnosis that gynecologists need to be aware of while managing such patients.
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Chachra V, Arora VK. Author's response. Indian J Tuberc 2014; 61:345. [PMID: 25682613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Rajpal S, Arora VK. Molecular diagnostics in tuberculosis revisited with clinicians' perspective. Indian J Tuberc 2014; 61:277-280. [PMID: 25675688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Goyal R, Garg PK, Bhatia A, Arora VK, Singh N. Clinical audit of repeat fine needle aspiration in a general cytopathology service. J Cytol 2014; 31:1-6. [PMID: 25190975 PMCID: PMC4150334 DOI: 10.4103/0970-9371.130612] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background: The few studies on repeat aspiration focussed on accuracy of diagnosis following repeat. Numbers and documented reasons for repeat remain unaddressed. Aim: To study factors associated with requests for repeat fine needle aspiration cytology (FNAC). Settings and Design: Metropolitan hospital, clinical audit. Materials and Methods: Audit of 5104 FNAC in 10 months. Statistical Analysis Used: Univariate, and multivariate binary logistic regression. Results: Seven hundred and six patients (13.8%) were advised repeat aspirates. Three hundred and twelve of these were actually repeated (44.1%). Carryover of actually repeated aspirates to subsequent months averaged 10.8 (34.2%). Maximum numbers of repeat requests were from thyroid 76/415 (18.3%), followed by lymph node 310/1856 (16.7%), and from breast 86/716 (12.0%). Outcome of actually repeated aspirates were: Diagnostic 181/312 (58.0%), and non-diagnostic 131/312 (41.9%). Reasons for repeat were inadequate aspirates 370/706 (52.4%), non-diagnostic descriptive reports 309/706 (43.7%); in 27/706 (3.8%), no reason was mentioned. Conclusions: Inadequate aspirates, non-diagnostic descriptive reports, and FNAC/FNAB from thyroid, lymph nodes, and breast contribute to repeats. We suggest steps to reduce the number of repeat aspirates to eliminate extra work.
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Sharma T, Jain S, Verma A, Sharma N, Gupta S, Arora VK, Dev Banerjee B. Gene environment interaction in urinary bladder cancer with special reference to organochlorine pesticide: a case control study. Cancer Biomark 2014; 13:243-51. [PMID: 24240585 DOI: 10.3233/cbm-130346] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Urinary bladder cancer (UBC) is a common disease worldwide with a higher incidence rate in developed countries. Organochlorine pesticides (OCPs), potent endocrine disrupters, are found to be associated with several cancers such as prostate, breast, bladder, etc. Glutathione S-transferase (GST) is a polymorphic supergene family involved in the detoxification of numerous environmental toxins including OCPs. The present study was carried out in UBC subjects (n=50) and healthy control subjects (n=50) with an aim to determine the role of GSTM1 and GSTT1 polymorphism and its implication on the OCP detoxification or bioaccumulation which may increase the risk of UBC in humans. This study was also designed to identify the "gene-environment interaction" specifically between gene polymorphism in xenobiotic metabolizing genetic enzyme(s) and blood OCP levels. GSTM1/GSTT1 gene polymorphism was analysed by using multiplex PCR. OCPs levels in whole blood were estimated by Gas chromatography equipped with electron capture detector. The results demonstrated a significant (p< 0.05) increase in frequency of GSTM1<formula>^{-}</formula>/GSTT1<formula>^{-}</formula> (null) genotype in UBC cases without interfering the distribution of other GSTT1/GSTM1 genotypes. The blood levels of alpha (α), Beta (β), Gamma (γ), total - Hexachlorcyclohexane (HCH) and para-para - dichlorodiphenyltrichloroetane (p,p'-DDT) were found to be significantly (p< 0.05) high in UBC cases as compared to controls. Multiple regression analysis revealed a significant interaction between β-HCH and GSTM1<formula>^{-}</formula> genotype (p< 0.05) as well as in β-HCH and GSTT1<formula>^{-}</formula> genotype (p< 0.05) respectively. These findings indicate that "gene-environment interaction" may play a key role in increasing the risk for UBC in individuals who are genetically more susceptible due to presence of GSTM1/GSTT1 null deletion during their routine encounter with or exposure to OCPs.
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Batra J, Arora VK. Oxidative stress and tuberculosis. Indian J Tuberc 2014; 61:183-185. [PMID: 25241564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Garg PK, Jain BK, Dahiya D, Bhatt S, Arora VK. Mesenteric liposarcoma: report of two cases with review of literature. J Gastrointest Cancer 2014; 45 Suppl 1:170-4. [PMID: 24781302 DOI: 10.1007/s12029-014-9612-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Karim A, Arora VK. Applications of ultrasonography in respiratory intensive care. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2014; 56:27-31. [PMID: 24930204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Emerging evidence suggests that ultrasonography of lung is a fast, inexpensive, widely available bed-side diagnostic tool which is useful for quick and early diagnosis of respiratory diseases. It is useful in the differential diagnosis of pulmonary infiltrates and has good accuracy in identifying consolidation and alveolar-interstitial syndrome. This technique can also be useful in the immediate evaluation of patients with dyspnoea or acute respiratory failure in the respiratory intensive care unit and helps in monitoring treatment response. Ultrasonography of lung has also been found to be useful in the diagnosis of pulmonary embolism, traumatic lung contusion and lung consolidation as well. There is a need for developing specific guidelines for establishing the standards of training and education regarding lung ultrasonography in India.
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Arora VK, Chopra KK. Changing role of Tuberculosis Association of India in 75 years. Indian J Tuberc 2014; 61:1-4. [PMID: 24640337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Singla R, Arora VK. Multi-drug resistant tuberculosis in India. Indian J Tuberc 2014; 61:9-11. [PMID: 24640339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Chachra V, Arora VK. Study on prevalance of diabetes mellitus in patients with T.B. under DOTS strategy. Indian J Tuberc 2014; 61:65-71. [PMID: 24640347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Tuberculosis is five to six times more common among diabetics than among non-diabetics and causes greater morbidity, according to reports. The effective control of each affects the control of the other. Diabetes increases the risk of developing tuberculosis, especially in developing countries with a high incidence of tuberculosis. DOTS strategy has been an effective tool on a mass basis. However, patients under DOTS are not screened for diabetes before the therapy. AIMS & OBJECTIVES To study the prevalence of diabetes mellitus in patients with tuberculosis under DOTS strategy. MATERIAL & METHODS A cross-sectional study was conducted in Santosh Medical College & Hospital, Ghaziabad, with the patients taken from different DOTS centres of NCR-Delhi, India. The present study was undertaken to evaluate the presence of undiagnosed diabetes under DOTS strategy. Fasting capillary blood glucose levels of patients diagnosed with tuberculosis were analyzed and were managed as per DOTS guidelines at multiple centres in the northwest region of India. RESULTS We studied 700 patients. The prevalence of diabetes was 12.6% (n=88), which is quite high. When category-wise analysis of diabetic subjects was done, it was found that patients under Category-I were 11.7% (n=47), patients under Cat-II were 15.5% (n=39) and those under Cat-III were 3.9% (n=2). The higher percentage of patients in Cat-II indicates the poor outcome of Cat-I patients, probably due to diabetes as a co-morbid disease. CONCLUSION The higher prevalence of diabetes mellitus in DOTS patients raises immediate concerns in preventing the morbidity due to both the diseases. Therefore, it is recommended that some strategy on the lines of HIV disease should be formed under DOTS for the concomitant treatment of TB and diabetes for better outcome and care.
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Prapanna P, Srivastava R, Arora VK, Singh N, Bhatia A, Kaur IR. Immunocytochemical detection of mycobacterial antigen in extrapulmonary tuberculosis. Diagn Cytopathol 2013; 42:391-5. [PMID: 24166859 DOI: 10.1002/dc.23049] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 07/10/2013] [Accepted: 08/28/2013] [Indexed: 11/09/2022]
Abstract
The aim of the study is to determine whether immunostaining for mycobacterial antigen can contribute to the cytological diagnosis of extrapulmonary tuberculosis (EPTB). The study was carried out on aspirated material of lymph nodes, and other accessible sites, from 65 patients with clinical diagnosis of tuberculosis (TB). Twenty patients, diagnosed by fine-needle aspiration, with non-tuberculous granulomas served as controls. The diagnosis of TB was based on the demonstration of acid-fast bacilli (AFB), culture positivity for Mycobacterium tuberculosis (M. tuberculosis), or response to treatment with standard anti-tubercular therapy. Immunostaining was done using polyclonal antibody to mycobacteria. AFB positivity by Ziehl Neelsen (ZN) staining was 21%, 65.38%, and 68% respectively in Pattern 1 (granulomas alone), in Pattern 2 (granulomas with necrosis), and in Pattern 3 (necrosis alone). Overall AFB positivity was 56.92%. Twenty-eight of 65 cases were negative for AFB on direct smear. Culture was positive in 46% (13/28). Sensitivity and specificity of immunostaining were 96.92% (63/65) and 95%, respectively. Immunoreactivity was seen in 26 (92.8%) of 28 cases which were negative by ZN staining. Except in the case of leprosy, in which cross reactivity was seen, there was no immunoreactivity in the control group. Immunocytochemistry (ICC) had high sensitivity (96.2%) and specificity (95%) in the diagnosis of EPTB. ICC may be a useful adjunct to evaluation of cytomorphology and ZN staining.
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Subramaneyaan M, Yasmeen S, Arora VK, Tripathi AK, Banerjee BD, Ahmed RS. Safety evaluation and therapeutic efficacy of Habb-e-Asgand, a commonly used antirheumatic polyherbal Unani formulation. Altern Ther Health Med 2013; 19:52-59. [PMID: 23981406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
CONTEXT Rheumatoid arthritis (RA) is a chronic autoimmune disorder. Habb-e-Asgand (HEA) is a polyherbal, Unani formulation widely used in the treatment of RA. Traditional systems of medicine or plant-based drugs are an attractive alternative treatment because of their professed efficacy in curing the disease. Medicinal herbs and herbal formulations are generally considered to be safer than the conventional drugs for RA. Unani drugs are known not to produce toxic effects and are presumed to be nontoxic. However, no objective, verifiable data exists to support the claims of nontoxicity and efficacy. OBJECTIVES The present study was designed to evaluate the safety and therapeutic efficacy of HEA in Wistar rats. SETTING The study took place at the University College of Medical Sciences and GTB Hospital, University of Delhi, Dilshad Garden, Delhi, India. DESIGN Oral toxicity studies--one acute (14 d) and one long-term (90 d)--were carried out using three doses of HEA--57.5, 115, and 230 mg/kg body weight (BWT)--in both male and female rats. The research team also carried out a study on antirheumatic activity. The team induced arthritis in three groups of male rats using collagen type II (CII), and for 20 d, one group was treated once weekly with saline; a second group was treated once weekly with methotrexate (MTX) at 0.25 mg/kg BWT IP; and a third group was treated daily with HEA at 115 mg/kg BWT orally. A control group received saline but was not induced with RA. OUTCOME MEASURES Rheumatoid factor (RF); anticyclic citrullinated peptide (a-CCP) antibody; antinuclear antibody (ANA); and C-reactive protein (CRP) were measured. RESULTS The acute and long-term, oral toxicity studies showed that HEA administration did not produce any overt toxicity or mortality and that it was safe at all dose levels tested. No major alterations were observed in hematology, serum biochemistry, necropsy, and histopathology at the therapeutic equivalent dose (ie, 115 mg/kg BWT). HEA administration for 20 d in arthritis-induced rats significantly reduced the levels of autoantibodies and CRP, and the results were comparable with those of MTX, the standard, disease-modifying antirheumatic drug (DMARD). CONCLUSION The study's results provided evidence that HEA is not toxic at the therapeutic dose. The antiarthritic activity of HEA may be due to its disease-modifying activities, thus supporting the traditional use of this formulation for treatment of RA.
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Bharathi SP, Raj HM, Jain S, Banerjee BD, Ahmed T, Arora VK. Role of pesticides in the induction of tumor angiogenesis. Anticancer Res 2013; 33:231-240. [PMID: 23267150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Due to their estrogen-mimicking ability, pesticides are considered as prime etiological suspects of increasing tumor incidence, although a direct link is still undefined. The present study aimed to identify the effect of xenoestrogens (lindane, propoxur and endosulfan) at 20 mg/l each on tumorigenesis, by evaluating endothelial cell proliferation, H(3) thymidine incorporation, wound healing, ascites formation and secretion, shell less Chorio Allantoic Membrane (CAM) formation using in vitro, as well as in vivo, models. The genotoxic effect of xenoestrogens in terms of DNA damage was also studied. The results showed that the endothelial cell proliferation, H(3) thymidine incorporation, wound healing, CAM formation were increased following xenoestrogen exposure, but the intensity of angiogenesis was dependent on the structural homology of these xenoestrogens to endogenous estrogen. Moreover, lindane was the most potent angiogenesis stimulator followed by propoxur and Endosulfan. Further studies were undertaken to examine lindane for its possible carcinogenicity. However, no effect was observed on the integrity of DNA after exposure to these xenoestrogens.
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Arora VK, Jaiswal AK, Jain V. Changing trends of cutaneous tuberculosis in the era of DOTS strategy. Indian J Tuberc 2012; 59:116-118. [PMID: 22838212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Arora VK, Sarungbam J, Bhatia A, Singh N, Agrawal V, Aggarwal S. Usefulness of NMP22 as an adjunct to a typical urine cytology and low-grade urothelial carcinoma. Diagn Cytopathol 2011; 38:788-90. [PMID: 20014314 DOI: 10.1002/dc.21286] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The usefulness of urine cytology combined with NMP22 was evaluated for the primary diagnosis of urothelial carcinoma. Of 53 clinically suspected patients, histopathological diagnoses were low-grade urothelial carcinoma (25), high-grade urothelial carcinoma (13), and inflammatory lesions (15). Cytology was positive in 25 and negative in 14 patients. Fourteen of 25 low-grade urothelial carcinoma and 11/13 high-grade urothelial carcinoma were diagnosed correctly on urine cytology. Atypical cells seen in 14 patients were categorized as inconclusive for malignancy. The overall sensitivity of urine cytology was 65.8%, whereas specificity was 100%. NMP22 was positive in 33 patients. Of these 30, 18 low-grade and 12 high-grade lesions were true positive. Of the 20 NMP22, eight negative cases were false-negative. Ten of 15 with negative histopathology were also negative for NMP22, three were false-positive, and two showed erratic results. Nine of 14 cases with atypical urine cytology were positive for NMP22. Eight of these showed low-grade carcinoma on histopathology. The sensitivity of BladderChek NMP22 test was 79%, whereas specificity was 80%. NMP22 BladderChek test is a useful adjunct to urine cytology in atypical and low-grade carcinoma.
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Srivastava R, Arora VK, Aggarwal S, Bhatia A, Singh N, Agrawal V. Cytokeratin-20 immunocytochemistry in voided urine cytology and its comparison with nuclear matrix protein-22 and urine cytology in the detection of urothelial carcinoma. Diagn Cytopathol 2011; 40:755-9. [PMID: 22888081 DOI: 10.1002/dc.21617] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2010] [Accepted: 11/13/2010] [Indexed: 11/06/2022]
Abstract
This study was done on 59 subjects (42 urinary bladder carcinoma patients and 17 non-neoplastic controls). Urine cytology and bladder chek NMP22 test was done on all cases. CK20 immunostaining was performed on archived papanicolaou stained urine cytology smears in 34 cases (27 bladder carcinoma and 7 negative controls). Results of all three tests (cytology, NMP22, and CK20 immunostaining) were compared with histopathology to evaluate the accuracy of individual test. The combination of cytology and NMP22 was compared with combination of cytology and CK20 immunostaining for detection of bladder carcinoma. NMP22 had sensitivity of 92.9% and specificity of 70.6%, as compared with voided urine cytology (sensitivity of 76.2% and specificity of 76.5%) and CK20 immunostaining (sensitivity of 70.4% and specificity of 71.4%). Combination of cytology and NMP22 gave better results (sensitivity of 88.1% and specificity of 88.2%) than combination of cytology and CK20 immunostaining or any other test in isolation.
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Arora VK, Chachra V. Stem cells and its importance in respiratory medicine with special reference to tuberculosis. Indian J Tuberc 2011; 58:1-3. [PMID: 21434550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Arora VK, Aggarwal S. An unusual variant of leiomyoma masquerading peroperatively as sarcoma. Indian J Cancer 2011; 48:120-1. [DOI: 10.4103/0019-509x.76636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chawla A, Aggrawal S, Makhija M, Arora VK. Perivascular localization of acid-fast bacilli in a necrotic cytologic smear. Acta Cytol 2010; 54:1084-1085. [PMID: 21053615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Dhingra VK, Hanif M, Mittal A, Gupta S, Rajpal S, Agarwal N, Arora VK. Study of different methods of susceptibility testing of M. tuberculosis. THE JOURNAL OF COMMUNICABLE DISEASES 2010; 42:111-121. [PMID: 22471170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This communication is on a multi-centre collaborative study carried out by New Delhi Tuberculosis (NDTB) Centre, Delhi, to compare the different methods of drug susceptibility testing (DST) of Mycobacterium tuberculosis for Streptomycin, Rifampicin, Isoniazid and Ethambutol in various accredited laboratories 40 samples (selected by simple random sampling technique) from sputum positive out-patients presenting between December 2004 and January 2005 were collected at New Delhi Tuberculosis Centre from 24 males and 16 females (age ranging from 18 to 55 years) were taken up for culture and susceptibility testing. The proportion method of DST done at NDTB Centre was taken as standard for comparing the other methods after it was found to have a good agreement with the proportion method performed at Tuberculosis Research Centre, Chennai (Kappa coefficient 0.75 to 1). All 40 sub-cultures were processed for DST by the resistance ratio and proportion methods at NDTB Centre. Also, the 40 sub-cultures were sent to Central JALMA Institute for Leprosy (JALMA), Agra that used the resistance ratio method and 25 sub-cultures were transported to National Institute of Communicable Diseases (NICD), Delhi for performing the Bactec 460TB method. The resistance ratio and proportion methods were compared both intra-laboratory (NDTB Centre) and inter-laboratory (NDTB Centre and JALMA). The sensitivity and specificity of the resistance ratio method compared to the proportion method both inter and intra-laboratory, were very high for all the drugs (except Ethambutol inter-laboratory). This was corroborated by the good agreement between the resistance ratio performed at the two centres. Bactec 460TB method, on the other hand, did not have acceptable measures of validity (sensitivity and specificity) compared to the proportion method for Streptomycin and Ethambutol. Both resistance ratio method & proportion method are comparable and either can be used for making clinical decisions. But Bactec 460 method, despite yielding early results loses out on validity.
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Gandhi A, Aggarwal S, Rajbongshi A, Arora VK. Bursal gouty tophus: fine-needle aspiration cytology intrabursal tophus on FNAC. Diagn Cytopathol 2009; 38:463-4. [PMID: 19927357 DOI: 10.1002/dc.21225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Aggarwal S, Gandhi A, Arora VK. Cytomorphological diagnosis of tendinous xanthomatosis: a case report. Diagn Cytopathol 2009; 38:287-9. [PMID: 19894253 DOI: 10.1002/dc.21204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Xanthoma is a reactive histiocytic proliferation in response to altered lipid levels. These develop usually in skin and subcutis but may also develop in deep soft tissue as tendon sheath or synovium. We report a rare case of tendinous xanthomatosis in a 23-year-old female, diagnosed on aspiration cytology.
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Dhingra VK, Malik S, Hanif M, Arora VK. XDR Tuberculosis: a report from the New Delhi Tuberculosis Centre, India. JCPSP-JOURNAL OF THE COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN 2009; 19:133-5. [PMID: 19208323 DOI: 02.2009/jcpsp.133135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 04/24/2008] [Accepted: 11/14/2008] [Indexed: 12/01/2022]
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Agarwal N, Kumar S, Dass J, Arora VK, Rathi V. Diffuse pancreatic serous cystadenoma associated with neuroendocrine carcinoma: a case report and review of literature. JOP : JOURNAL OF THE PANCREAS 2009; 10:55-58. [PMID: 19129617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
CONTEXT Diffuse serous cystadenomas of the pancreas are extremely rare, with only 8 cases reported previously, and have been associated with neuroendocrine tumors in only two patients. Some have been seen in von Hippel-Lindau disease. The management of these tumors poses a challenge due to their rarity and uncertain malignant potential. We report a case of diffuse serous cystadenoma associated with neuroendocrine carcinoma in a 35-year-old woman. CASE REPORT A 35-year-old woman with mild abdominal pain was diagnosed as having a cystic pancreatic mass on ultrasonography. On contrast-enhanced CT scan, MRI and MRCP imaging, a spongy lesion was found to replace the entire pancreas, and was diagnosed as diffuse serous cystadenoma. Serum biochemistry for amylase, lipase, CA 19-9 and CEA was normal. Screening for retinal and CNS lesions was also unremarkable. A total pancreatectomy was performed, and the patient recovered well. Histopathological examination of the specimen revealed microcysts and macrocysts replacing the entire pancreas, the largest being 3.5 cm. The cysts were lined with a single layer of cuboidal to flattened cells. An endocrine tumor abutting the cystic component was found, having neoplastic cells in a trabecular pattern. Metastasis of the neuroendocrine component was seen in the adherent lymph nodes. A diagnosis of diffuse serous cystadenoma associated with neuroendocrine carcinoma was made. CONCLUSION Diffuse serous cystadenomas of the pancreas are extremely rare tumors. In young patients, they may harbour associated malignancy, and may be the first presentation of von Hippel-Lindau disease. Aggressive surgical resection with long-term follow-up may be worthwhile in this group of patients.
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Sharma SG, Mathur SR, Aron M, Iyer VK, Arora VK, Verma K. Chromophobe renal cell carcinoma with calcification: Report of a case with rare finding on aspiration smears. Diagn Cytopathol 2008; 36:647-50. [PMID: 18677748 DOI: 10.1002/dc.20861] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Chromophobe renal cell carcinoma (ChRCC) is a distinct variant of renal cell carcinoma. It is important to identify this entity because it has a significantly better prognosis than clear cell (conventional) renal cell carcinoma. We report the case of a 56-year-old male who presented with 10 days history of painless hematuria. There was no palpable swelling or systemic symptoms. On radiological examination the possibility of a right renal neoplasm was considered. Ultrasound guided aspiration was done and cytological features of ChRCC were noted. In addition, numerous foci of calcification were seen, which was an unusual cytological feature for ChRCC. The characteristic cytomorphology of ChRCC makes it possible to render a preoperative diagnosis on fine needle aspiration cytology (FNAC). We report the case to emphasize the importance and possibility of diagnosing of ChRCC on cytology. In addition, the extensive calcification as seen in our case is an unusual cytological finding not previously reported in cytology smears.
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Bhatia V, Garg PK, Arora VK, Sharma R. Isolated pancreatic tuberculosis mimicking intraductal pancreatic mucinous tumor. Gastrointest Endosc 2008; 68:610-1. [PMID: 18359483 DOI: 10.1016/j.gie.2007.12.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2007] [Accepted: 12/17/2007] [Indexed: 12/26/2022]
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80
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Arora VK, Singla R, Dhingra VK, Prasad R. Panel discussion on MDR and XDR TB. Moderated by Dr. V.K. Arora. Indian J Tuberc 2008; 55:104-109. [PMID: 18516829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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81
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Dhingra VK, Rajpal S, Mittal A, Gupta UA, Arora VK. Tuberculosis of the ilium: a case report. THE JOURNAL OF COMMUNICABLE DISEASES 2008; 40:79-82. [PMID: 19127675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A twenty year old man presented with pain in the upper part of right hip. CT scan showed multiple osteolytic areas in the right ilium, suggesting malignancy. CT guided needle biopsy was done and diagnosis of tuberculosis was made. The patient was cured with medical management only. Isolated tuberculosis of the ilium is an extremely rare condition. It is important to have a high clinical suspicion to diagnose early and manage the patient without surgical intervention.
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Kakumanu VK, Arora VK, Bansal AK. Gastro-retentive dosage form for improving bioavailability of Cefpodoxime proxetil in rats. YAKUGAKU ZASSHI 2008; 128:439-45. [PMID: 18311064 DOI: 10.1248/yakushi.128.439] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
Abstract
Cefpodoxime proxetil (CP) is a prodrug with poor oral bioavailability because of its metabolism to Cefpodoxime acid (CA) in luminal contents and intestinal epithelial cells. In the present investigation, regional variability in different segments of the gastrointestinal tract vis-à-vis solubility and metabolism were investigated, and the results indicated potential for a gastro retentive (GR) dosage form. Suitability of a GR dosage from for CP and finally in vivo efficacy were investigated. Thereafter, an effervescent floating GR dosage form was developed for CP and evaluated in rats. The GR dosage form improved the oral bioavailability of CP significantly by about 75%, hence providing a proof-of-concept. The Tmax value increased to 1.43+/-0.24 h from 0.91+/-0.23 h of pure drug, while Cmax values of 4735+/-802 ng/ml and 3094+/-567 ng/ml were obtained for the GR dosage form and pure drug respectively.
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83
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Arora VK, Chopra KK. Extra pulmonary tuberculosis. Indian J Tuberc 2007; 54:165-167. [PMID: 18072528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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84
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Arora VK, Chauhan LS, Solanki RN, Ahir GC, Sarin R, Chopra KK. Panel discussion on RNTCP implementation--problems and solutions. Indian J Tuberc 2007; 54:140-4. [PMID: 17886703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
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85
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Lakra A, Singh N, Arora VK, Bhatia A, Bhattacharya SN. Tuberculoid morphology in borderline lepromatous leprosy. Acta Cytol 2007; 51:491-2. [PMID: 17536565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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86
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Singla R, Kumar A, Chauhan D, Juneja D, Tyagi VN, Arora VK. Endobronchial tuberculosis presenting as tumorous mass. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2007; 49:45-7. [PMID: 17256567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
We report a case of an 18-year-old boy presenting with features of right middle lobe collapse. On bronchoscopy, a tumorous type of endobronchial tuberculosis was found to be obstructing the lumen of the right middle lobe bronchus. On treatment with anti-tuberculous drugs the growth resolved significantly within three months. The patient, however, developed mild stenosis of the airway.
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Singh N, Bhatia A, Lakra A, Arora VK, Bhattacharya SN. Comparative cytomorphology of skin, lymph node, liver and bone marrow in patients with lepromatous leprosy1. Cytopathology 2006; 17:257-61. [PMID: 16961654 DOI: 10.1111/j.1365-2303.2006.00323.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study was to compare the cytological changes in skin, lymph nodes, liver and bone marrow in patients with lepromatous leprosy. METHODS Skin lesion, lymph node, liver and bone marrow aspirates were analysed. May-Grunwald-Giemsa (MGG) and Ziehl-Neelsen (Z-N) stains were employed. Comparative cytomorphology was studied. RESULTS Twenty patients with lepromatous leprosy were studied. Lepra cells (LC) predominated in the skin aspirates of 12 patients with lepromatous leprosy (LL), lymphocytes accompanied LC in eight patients with borderline-lepromatous (BL) leprosy. Three patients of LL leprosy and two of BL leprosy in type 2 reaction additionally had numerous neutrophils. Two patterns of lymph node aspirates were seen: partial replacement with few LC in a reactive lymphoid background (10), complete replacement with either only LC or LC in a background of degenerating neutrophils (10), the latter a feature of type 2 reaction. Liver aspiration was performed in seven patients and of bone marrow in eight patients. Occasional LC were present in five liver-aspirated patients, steatosis and Kupffer cell hyperplasia in four patients, and myelopoiesis in two patients. Bone marrow smears invariably had occasional LC and a relative increase in mature plasma cells; sea-blue histiocytes were seen in six patients. CONCLUSION Lepra cells predominated in skin and lymph node aspirates with complete replacement. In comparison, liver, bone marrow and lymph node aspirates with partial replacement were dominated by a preponderance of cells native to these organs with only few or occasional LC.
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Floyd K, Arora VK, Murthy KJR, Lonnroth K, Singla N, Akbar Y, Zignol M, Uplekar M. Cost and cost-effectiveness of PPM-DOTS for tuberculosis control: evidence from India. Bull World Health Organ 2006; 84:437-45. [PMID: 16799727 PMCID: PMC2627367 DOI: 10.2471/blt.05.024109] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To assess the cost and cost-effectiveness of the Public-Private Mix DOTS (PPM-DOTS) strategy for tuberculosis (TB) control in India. METHODS We collected data on the costs and effects of pilot PPM-DOTS projects in Delhi and Hyderabad using documentary data and interviews. The cost of PPM-DOTS was compared with public sector DOTS (i.e. DOTS delivered through public sector facilities only) and non-DOTS treatment in the private sector. Costs for 2002 in US$ were assessed for the public sector, private practitioners, and patients/attendants. Effectiveness was measured as the number of cases successfully treated. FINDINGS The average cost per patient treated was US$ 111-123 for PPM-DOTS and public sector DOTS, and US$ 111-172 for non-DOTS treatment in the private sector. From the public sector's perspective, the cost per patient treated was lower in PPM-DOTS projects than in public sector DOTS programmes (US$ 24-33 versus US$ 63). DOTS implementation in either the public or private sectors improved treatment outcomes and substantially lowered costs incurred by patients and their attendants, compared to non-DOTS treatment in the private sector (US$ 50-60 for DOTS compared to over US$ 100 for non-DOTS). The average cost-effectiveness of PPM-DOTS and public sector DOTS was similar, at US$ 120-140 per patient successfully treated, compared to US$ 218-338 for non-DOTS private sector treatment. Incremental cost-effectiveness analysis showed that PPM-DOTS can improve effectiveness while also lowering costs. CONCLUSION PPM-DOTS can be an affordable and cost-effective approach to improving TB control in India, and can substantially lower the economic burden of TB for patients.
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Kakumanu VK, Arora VK, Bansal AK. Development and validation of isomer specific RP-HPLC method for quantification of cefpodoxime proxetil. J Chromatogr B Analyt Technol Biomed Life Sci 2006; 835:16-20. [PMID: 16517228 DOI: 10.1016/j.jchromb.2006.02.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2006] [Revised: 02/15/2006] [Accepted: 02/17/2006] [Indexed: 11/27/2022]
Abstract
The present work explains the development and validation of a simple and reliable isomer specific liquid chromatographic method for the quantitative determination of cefpodoxime proxetil (CP) in rat in situ intestinal perfusate samples. Chromatography was carried out by reversed-phase technique on a C-18 column with a mobile phase composed of 20 mM ammonium acetate buffer (pH 5.0) and acetonitrile in the ratio of 62:38 pumped at a flow-rate of 1 ml/min. The detection was carried out at 235 nm and a column temperature of 30 degrees C. The method was evaluated for the various validation parameters, such as linearity, accuracy, precision, LOD, LOQ, specificity, selectivity, and sample stability. The results of intra- and inter-day validation (n = 3) showed the method to be efficient and the same was applied in an in situ permeability study conducted for CP in rats.
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Singh I, Pachisia SS, Kumar S, Arora VK, Kumar P. Emphysematous pyelonephritis: a consequence of adenocarcinoma of urinary bladder in a nondiabetic patient. J Postgrad Med 2005; 51:324-5. [PMID: 16388179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Emphysematous pyelonephritis (EP) is a life threatening condition of acute necrotising renal parenchymal infection that encompasses a much wider spectrum of complicated urinary tract infections such as renal abscesses, emphysematous pyelitis, pyelonephritis, acute renal papillary necrosis, and sepsis. We report an unusual case of adenocarcinoma bladder in a middle aged nondiabetic patient, presenting with EP. Emphysematous pyelonephritis was the initial symptom in this case with an underlying carcinoma of the bladder. The role of imaging is prime in management of such cases, if an early diagnosis is to be made and a potentially devastating outcome is to be avoided. The literature regarding EP has been reviewed and discussed. The goals of managing EP should be (1) early institution of parenteral antibiotics and a (2) a staged nephrectomy (preceded by a temporary percutaneous drainage particularly with antibiotic resistant septicemia) so as to maximize survival rather than proceeding directly to emergency nephrectomy.
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Arora VK, Kumar S, Singh N, Bhatia A. Intraoperative bile cytology of the dysplasia-carcinoma in situ sequence of gallbladder carcinoma. Cancer 2005; 105:277-81. [PMID: 16047358 DOI: 10.1002/cncr.21320] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The preoperative diagnosis of noninvasive and early carcinoma of the gallbladder is considered to be both difficult and exceptional. In the current study, the authors conducted a cytologic analysis of bile in the intraoperative diagnosis of clinically unsuspected gallbladder carcinoma. METHODS Bile samples collected from 40 patients at the time of elective cholecystectomy were centrifuged. Smears prepared from the sediments were stained with May-Grünwald-Giemsa and Papanicolaou stains. Lesions were categorized as hyperplasia with or without metaplasia, dysplasia, carcinoma in situ, and invasive carcinoma. Cytologic diagnoses were compared with histopathology. RESULTS Two cases of carcinoma in situ and one case of invasive carcinoma diagnosed on bile cytology were confirmed by histopathology. No false-positive diagnoses were made based on cytologic examination of aspirated bile. Cytohistologic concordance in cases of hyperplasia, dysplasia, and chronic cholecystitis varied from 56-60%. CONCLUSIONS Intraoperative bile cytology was found to be a reliable method for the detection of in situ and early invasive carcinoma of the gallbladder.
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Singla R, Singla N, Sarin R, Arora VK. Influence of pre-treatment bacillary load on treatment outcome of pulmonary tuberculosis patients receiving DOTS under revised national tuberculosis control programme. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2005; 47:19-23. [PMID: 15704711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
OBJECTIVE To study the influence of initial bacillary load on sputum conversion rates and treatment outcome of new smear positive pulmonary tuberculosis patients. METHODS A retrospective study was done among 2938 new smear positive pulmonary tuberculosis patients, registered at the peripheral centres, covering a population of 1.6 million in Delhi, India. The patients pre-treatment sputum smears were graded as 1+, 2+ or 3+ based on three samples. Patients were given intermittent short-course chemotherapy under supervision and the treatment outcome was analysed. RESULTS Sputum conversion rates among patients graded as sputum 3+ and rest of the patients (combined graded sputum 1+ and 2+) at the end of two months were 62.2% and 76.8% respectively (p<0.001), and at the end of three months were 81.3% and 89.5% respectively (p<0.001). Cure rates among same group of patients were 76.6% and 85.1% respectively (p<0.001), and failure rates were 7.7% and 4.5% respectively (p<0.001). CONCLUSIONS Under field conditions even with directly observed treatment (DOT) new smear positive patients with heavy bacillary load showed statistically significant poor sputum conversion rates at two and three months and higher failure rates as compared to patients with lesser bacillary load. To investigate possible reasons for this poor response and possible solutions further studies are needed.
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93
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Chauhan LS, Arora VK. Management of pediatric tuberculosis under the Revised National Tuberculosis Control Program (RNTCP). Indian Pediatr 2004; 41:901-5. [PMID: 15475631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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94
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Arora VK. Issues in pediatric tuberculosis under DOTS strategy. Indian Pediatr 2004; 41:891-3. [PMID: 15475629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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95
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Gupta R, Arora VK. Performance evaluation of APACHE II score for an Indian patient with respiratory problems. Indian J Med Res 2004; 119:273-82. [PMID: 15243165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND & OBJECTIVES Realising the utility of scoring systems in mortality prediction of critically ill patients admitted to intensive care units (ICUs), studies worldwide have expressed a need to validate the Acute Physiology and Chronic Health Evaluation (APACHE) II score for databases of respective countries. Literature available in this area in the Indian context is scanty. The present study was undertaken to evaluate the performance of APACHE II score in prediction of mortality risk, as well as in determination of model validity in critically ill Indian patients with respiratory problems. METHODS The study was prospectively carried out over 18 months at respiratory ICU of a tertiary Institute in New Delhi, which admitted consecutive medical (with lung ailments) and surgical (who had undergone any elective thoracic surgical procedure under general anaesthesia) patients. Based on chief indication of ICU admission, the medical patients were further divided into sub-groups I (respiratory) and II (non-respiratory). APACHE II points were assigned to all patients for calculating their individual predicted risks of mortality. Standard mortality ratio (SMR) was computed with 95 per cent confidence intervals (CI). Calibration of model was analysed by calculating Lemeshow and Hosmer goodness of fit X(2) statistic and by plotting calibration curve, whereas discrimination was evaluated by calculating area under a receiver operating characteristic (ROC) curve. RESULTS Of the 393 consecutive patients admitted to respiratory ICU during the study period, 63 were left out on account of exclusion criteria. Mean APACHE II score of the remaining 330 patients was 12.87+/-8.25 and range from 1 to 47. There were 287 (87%) survivors and 43 (13%) non-survivors, whose mean APACHE II scores, being respectively 11.34+/-6.75 (range 1-37) and 23.09+/-10.01 (range 5-47), were significantly different (P<0.01). The study had a predicted mortality of 7.9 per cent and an SMR value of 1.65 (95% CI from 0.4 to 3.0). Mean APACHE II score of those having medical ailments was significantly higher (P<0.01) than surgical patients. The non-respiratory sub-group had a significantly higher (P<0.01) mean APACHE II score than respiratory sub-group. 59 per cent of patients did not get APACHE II points owing to being <45 yr of age. In addition, against 10 immunocompromised patients, 77 others did not get APACHE II points despite having apparently compromised immunity due to co-existence of tuberculosis (TB), diabetes mellitus, dual pathologies or past history of anti-TB treatment. Observed and predicted mortality rose with 5-point APACHE II score, but did not correlate for patients of any comparable group. Average ICU stay of 16 days for those with medical disease was significantly longer (P<0.01) than 9.5 days for surgical patients. APACHE II scoring system showed a poor calibration and discrimination ability for Indian respiratory patients. INTERPRETATION & CONCLUSION Despite the rise in observed and predicted mortality with 5-point APACHE II score, predicted mortality did not correlate with observed mortality for critically ill patients admitted to an Indian respiratory ICU. The scoring system also showed a poor calibration as well as discrimination. The model may be more useful for Indian patients by lowering down the cut-off value in allotment of age points and by awarding the weightage to factor like co-existing immunocompromised state.
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Arora R, Rajaram P, Oumachigui A, Arora VK. Prospective analysis of short course chemotherapy in female genital tuberculosis. Int J Gynaecol Obstet 2004; 38:311-4. [PMID: 1358690 DOI: 10.1016/0020-7292(92)91024-i] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Short course chemotherapy with 2SHRZ/7HR of 9 months duration was given in 41 proven cases of female genital tuberculosis. Thirty-two (78%) patients completed 9 months of therapy. Twenty-five (61%) were pronounced cured. Short course chemotherapy appears to be quite effective in patients of genital tract tuberculosis.
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Chauhan LS, Arora VK. Management of pediatric tuberculosis under the revised national tuberculosis control programme. Indian J Pediatr 2004; 71:341-3. [PMID: 15107516 DOI: 10.1007/bf02724102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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98
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Arora VK, Lonnroth K, Sarin R. Improved case detection of tuberculosis through a public-private partnership. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2004; 46:133-6. [PMID: 15072331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Case detection of tuberculosis under public DOTS programmes is still low and there is currently a search for new ways to improve these programmes. We investigated the impact of a public-private partnership DOTS programme on tuberculosis case detection in New Delhi, India. Time series of case detection in an intervention and a control area were analysed through segmented linear regression modelling. We found that a significant positive trend shift occurred in the intervention area as compared to the control area after the partnership was initiated. The study indicates that public-private partnership is feasible way to improve TB case detection.
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Gupta R, Sircar M, Jaiswal A, Arora VK, Gupta K, Visalakshi P, Myneedu VP. A thyroid tubercular abscess and bilateral symmetrical hilar lymphadenopathy: a rare association. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2004; 46:121-4. [PMID: 15072328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
An 18-year-old boy presented with a rare association of a thyroid tubercular abscess and bilateral symmetrical hilar lymphadenopathy. He was put on a Category I regimen with standard short course daily chemotherapy of four anti-tubercular drugs under the National Tuberculosis Programme. After a six-month of anti-tubercular treatment (ATT), the boy showed clinical and bacteriological improvement. The thyroid scan with Technetium 99 (Tc 99) and the chest skiagram also became normal.
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Khanna P, Devgan SC, Arora VK, Shah A. Hydrocarbon pneumonitis following diesel siphonage. THE INDIAN JOURNAL OF CHEST DISEASES & ALLIED SCIENCES 2004; 46:129-32. [PMID: 15072330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
In our country, siphoning of diesel/petrol from fuel tanks is a common practice. We describe a 50-year-old farmer, who accidentally aspirated fuel while siphoning from his tractor. A diagnosis of diesel induced aspiration pneumonitis was confirmed by the presence of foam cells on bronchial biopsy. The patient showed gradual recovery with the symptomatic therapy. However two weeks later, he developed sudden chest pain and irregularly irregular pulse that proved fatal. Diesel aspiration leading to bilateral pneumonitis is yet to be reported in our country.
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