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Wilks J, Liebig C, Agarwal N, Shen X, He D, Wheeler T, Albo D. 59: Thrombospondin-1, Through Angiocidin, Up-Regulates Gelatinase Expression in Colon Cancer Cells. J Surg Res 2009. [DOI: 10.1016/j.jss.2008.11.823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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202
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Abstract
Colorectal carcinoma (CRC) is rare in children, except for a few sporadic reports there is not much information about it in the literature. It is important for pediatricians and paediatric surgeons to be aware that CRC does occur in children, and it should not be excluded only on the basis of the patient's age. Its rarity in children has meant a poor understanding of its biological nature and the treatment modalities to be followed.
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Saha S, Agarwal N, Srivastava A, Kumar A. Perforation peritonitis due to gastrointestinal cryptococcosis as an initial presentation in an AIDS patient. Singapore Med J 2008; 49:e305-e307. [PMID: 19037535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
A 30-year-old woman underwent exploratory laparotomy for perforation peritonitis. Primary repair of the jejunal perforation was performed. The ulcer edge biopsy revealed Cryptococcus. Subsequently ELISA was reactive for HIV-1 antibody. This report describes a rare case of cryptococcal jejunal perforation, which was the initial presentation in an AIDS patient.
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Verma VP, Kaur N, Agarwal N, Bhargava SK, Singh UR, Saha S, Raheja A. Intra-operative measurement of tumour size in breast cancer and its comparison with other methods: a prospective study. Ecancermedicalscience 2008; 2:96. [PMID: 22275977 PMCID: PMC3234070 DOI: 10.3332/ecancer.2008.96] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Indexed: 11/16/2022] Open
Abstract
Accurate measurement of breast tumour size determines staging and prognosis. Discrepancies amongst clinical examination (CE), ultrasonography (USG), mammography, pathological examination (PE) and magnetic resonance imaging have been reported. However, few studies have evaluated changes in breast tumour size from the operating table to the laboratory.
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205
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Agarwal N, Bellani M, Perlini C, Rambaldelli G, Atzori M, Cerini R, Vecchiato F, Pozzi Mucelli R, Andreone N, Balestrieri M, Tansella M, Brambilla P. Increased fronto-temporal perfusion in bipolar disorder. J Affect Disord 2008; 110:106-14. [PMID: 18291534 DOI: 10.1016/j.jad.2008.01.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2007] [Revised: 01/11/2008] [Accepted: 01/11/2008] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Previous imaging reports showed over-activation of fronto-limbic structures in bipolar patients, particularly in response to emotional stimuli. In this study, for the first time, we used perfusion weighted imaging (PWI) to analyze lobar cerebral blood volume (CBV) in bipolar disorder to further explore the vascular component to its pathophysiology. METHODS Fourteen patients with DSM-IV bipolar disorder (mean age+/-SD=49.00+/-12.30 years; 6 males, 8 females) and 29 normal controls (mean age+/-SD=45.07+/-10.30 years; 13 males, 16 females) were studied. PWI images were obtained following intravenous injection of paramagnetic contrast agent (Gadolinium-DTPA), with a 1.5 T Siemens magnet using an echo-planar sequence. The contrast of enhancement (CE), was calculated pixel by pixel as the ratio of the maximum signal intensity drop during the passage of contrast agent (Sm) by the baseline pre-bolus signal intensity (So) (CE=Sm/So*100) for frontal, temporal, parietal, and occipital lobes, bilaterally, on two axial images. Higher CE values correspond to lower CBV and viceversa. RESULTS Bipolar patients had significantly lower CE values in left frontal and temporal lobes (p=0.01 and p=0.03, respectively) and significantly inverse laterality index for frontal lobe (p=0.017) compared to normal controls. No significant correlations between CE measure and age or clinical variables were found (p>0.05). CONCLUSION This study found increased left frontal and temporal CBV in bipolar disorder. Fronto-temporal hyper-perfusion may sustain over-activation of these structures during emotion modulation, which have been observed in patients with bipolar illness.
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Fatma N, Kubo E, Sen M, Agarwal N, Thoreson WB, Camras CB, Singh DP. Peroxiredoxin 6 delivery attenuates TNF-alpha-and glutamate-induced retinal ganglion cell death by limiting ROS levels and maintaining Ca2+ homeostasis. Brain Res 2008; 1233:63-78. [PMID: 18694738 DOI: 10.1016/j.brainres.2008.07.076] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2008] [Revised: 07/11/2008] [Accepted: 07/14/2008] [Indexed: 01/01/2023]
Abstract
Higher expression of reactive oxygen species (ROS) is implicated in neurological disorders. A major event in glaucoma, the death of retinal ganglion cells (RGCs), has been associated with elevated levels of glutamate and TNF-alpha in the RGCs' local microenvironment. Herein we show that the transduction of Peroxiredoxin 6 (PRDX6) attenuates TNF-alpha- and glutamate-induced RGC death, by limiting ROS and maintaining Ca2+ homeostasis. Immunohistochemical staining of rat retina disclosed the presence of PRDX6 in RGCs, and Western and real-time PCR analysis revealed an abundance of PRDX6 protein and mRNA. RGCs treated with glutamate and/or TNF-alpha displayed elevated levels of ROS and reduced expression of PRDX6, and underwent apoptosis. A supply of PRDX6 protected RGCs from glutamate and TNF-alpha induced cytotoxicity by reducing ROS level and NF-kappaB activation, and limiting increased intracellular Ca2+ influx. Results provide a rationale for use of PRDX6 for blocking ROS-mediated pathophysiology in glaucoma and other neuronal disorders.
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Chandra H, Jamaluddin K, Masih L, Faiyaz K, Agarwal N, Kumar D. HIV/AIDS awareness through mass media--the measurement of efforts made in an urban area of India. Indian J Public Health 2008; 52:171-172. [PMID: 19189844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
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208
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Khadilkar UN, Agarwal N, Bhat V. Primary meningeal melanocytoma. Kathmandu Univ Med J (KUMJ) 2008; 6:245-247. [PMID: 18769099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Meningeal melanocytoma is an uncommon benign pigmented primary lesion that has to be distinguished as a pathological entity separate from other benign melanin containing tumours as well as its overtly malignant counterpart, melanoma. In the present study, a 58 year old lady presented with bilateral sensory and motor symptoms in the lower limbs. The MRI scan showed a dumb-bell shaped lesion in the spinal canal at 6th cervical vertebra to 1st thoracic vertebra (C6-T1) level mimicking a schwannoma and histologically proved to be melanocytoma.
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Kriplani A, Garg P, Agarwal N. 168: Total Laparoscopic Hysterectomy Using Ligasure Uterine Artery Sealing Device- Experience at AIIMS. J Minim Invasive Gynecol 2007. [DOI: 10.1016/j.jmig.2007.08.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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210
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Agarwal N, Lal S. 7: Treatment of Proximal Tubal Block by Laparoscopy Guided Hysteroscopic Tubal Cannulation. J Minim Invasive Gynecol 2007. [DOI: 10.1016/j.jmig.2007.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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211
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Kriplani A, Dash B, Mandal K, Garg P, Bhatia N, Agarwal N. The Role of Uterine Artery Ligation in Increasing Feasibility and Safety of Myomectomy During Cesarean Section. J Gynecol Surg 2007. [DOI: 10.1089/gyn.2007.b-02266-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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212
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Kriplani A, Singh BM, Lal S, Agarwal N. Efficacy, acceptability and side effects of the levonorgestrel intrauterine system for menorrhagia. Int J Gynaecol Obstet 2007; 97:190-4. [PMID: 17382331 DOI: 10.1016/j.ijgo.2007.01.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2006] [Revised: 01/14/2007] [Accepted: 01/16/2007] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the efficacy, acceptability, and possible side effects of a levonorgestrel-releasing intrauterine system for menorrhagia. METHODS Sixty-three women with menorrhagia but without uterine enlargement, endometrial hyperplasia with atypia, or endometrial carcinoma were enrolled in this prospective, open, nonrandomized clinical trial. An intrauterine system releasing 20 microg/day of levonorgestrel (LNG-IUS; Mirena, Shering, Finland) was inserted in the postmenstrual phase. Menstrual pattern, number of bleeding days, and subjective and objective estimation of menstrual blood loss using a pictorial blood loss assessment chart (PBAC) were recorded before insertion and at specific intervals for 4 years. Hemoglobin levels and endometrial thickness were evaluated at baseline and at 12 months. Treatment continuation and hysterectomy rates were noted as well as side effects. RESULTS The device was expelled spontaneously in 6 patients (9.52%) and removed prematurely in 9 patients (14.3%); 3 patients (4.8%) were lost to follow-up; and 45 patients (71.4%) continued with the LNG-IUS. Menorrhagia was cured in 35 (77.7%) of these 45 patients at 3 months and in all patients at 36 months. There was a significant decrease in the mean number of bleeding days (P=0.01) and PBAC score (P=0.00) at 1 month, and the decrease continued with treatment duration. The subjective blood loss reduction was considerable as well, and at 12 months the mean+/-SD rise in hemoglobin concentration was 1.06+/-1.7 g/dL (P=0.000). Endometrial thickness was decreased by 3.4+/-3.53 mm (P=0.0001) at 12 months. The most common side effect was intermenstrual spotting during the first 6 months, and 18 patients (28.57%) developed amenorrhea. CONCLUSION Using the LNG-IUS is an effective and well-accepted option overall for the medical management of menorrhagia.
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Liebig C, Agarwal N, Ayala G, Verstovsek G, Tuszynski G, Albo D. 77. J Surg Res 2007. [DOI: 10.1016/j.jss.2006.12.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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214
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Agarwal N, Liebig C, Tuszynski G, Bharadwaj U, Albo D. 168. J Surg Res 2007. [DOI: 10.1016/j.jss.2006.12.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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215
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Agarwal N, Liebig C, Tuszynski G, Bharadwaj U, Gupta N, Albo D. 170. J Surg Res 2007. [DOI: 10.1016/j.jss.2006.12.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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216
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Arya SC, Agarwal N. Re: Relationship between vaccine vial monitors and cold chain infrastructure in a rural district of India. Rural Remote Health 2007; 7:730. [PMID: 17355183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
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217
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Arya SC, Agarwal N, Agarwal S. Evaluating broad-spectrum antimicrobials. QJM 2006; 99:718-9. [PMID: 16956924 DOI: 10.1093/qjmed/hcl100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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218
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Guleria K, Bansal S, Agarwal N, Grover V. Women with septic abortion: who, how and why? A prospective study from tertiary care hospital in India. Indian J Public Health 2006; 50:95-6. [PMID: 17191411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
A prospective descriptive interview based hospital study was carried on 47 women admitted with septic abortion to evaluate their psychosocial, demographic and clinical profile These women were predominantly parous (75%), hindus (60%), between 20-30 years of age (60%) and mostly married (91.4%) house wives (63.8%). More than 90% already had one or more male child. The contraceptive use was dismally low (23.4%). Their knowledge about legalisation, place and persons authorized to conduct abortions was very less, however large majority (87%) underwent abortions within 3 months of pregnancy. Large family, poverty and spacing were the main reasons cited for abortions. Abdominal pain, fever, genital bleeding, diarhoea and abdominal distension were presenting clinical features in order of frequency. Advanced sepsis and associated medical and surgical complications were present in more than half the patients and 6% succumbed to these problems. The current experience was an eye opener for most of them and changed their future attitude. Hence education, economic prosperity, easy access to reproductive health facilities and institutional management of sepsis is the key to make abortions safe.
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Sharma BC, Agarwal N, Garg S, Kumar R, Sarin SK. Endoscopic management of liver abscesses and cysts that communicate with intrahepatic bile ducts. Endoscopy 2006; 38:249-53. [PMID: 16528651 DOI: 10.1055/s-2005-921117] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND STUDY AIMS The formation of a communication between liver abscesses or cysts and intrahepatic bile ducts is an uncommon cause of significant bile leak. Surgical management of biliary fistulas is associated with high morbidity and mortality. We performed a prospective study of endoscopic management of this type of biliary fistula. PATIENTS AND METHODS We studied 26 patients who had either liver abscesses or hepatic cysts that had ruptured into the intrahepatic bile ducts. The presence of a biliary fistula was suspected by jaundice and/or by the appearance of bile in percutaneous drainage effluent from a liver abscess and was confirmed by endoscopic retrograde cholangiopancreatography. Once the route of the fistula between the liver abscess or cyst and the intrahepatic bile duct had been defined by cholangiography, patients underwent treatment by sphincterotomy, and either biliary stenting or nasobiliary drainage. Nasobiliary drains or biliary stents (both 7 Fr) were placed according to standard techniques. Nasobiliary drains were removed when bile leakage stopped and closure of the fistula was confirmed by cholangiography; stents were removed after an interval of 4-6 weeks. RESULTS Of a total of 525 patients with hepatic abscesses or cysts who were seen over a 5-year period, there were 26 patients who developed a demonstrable communication between liver abscesses (n = 20; 16 amebic, four pyogenic) or hydatid cysts (n = 6) and intrahepatic bile ducts (right intrahepatic bile ducts in 22 patients, left intrahepatic bile ducts in four patients). We performed either sphincterotomy with insertion of a nasobiliary drain (n = 20) or sphincterotomy with biliary stenting (n = 6). The fistulas healed in all patients after a mean time of 4 days (range 2-20 days) after endoscopic treatment. We were able to remove the nasobiliary drainage catheters and stents 6-34 days after their placement. CONCLUSIONS In this case series, endoscopic therapy appears to be an effective mode of treatment for biliary fistulas complicating liver abscesses and cysts.
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Nijhawan S, Mathur A, Kumar D, Tandon M, Rastogi M, Joshi A, Shende A, Agarwal N, Rai RR. Achalasia cardia: A study of 113 patients managed with indigenous dilator. TROPICAL GASTROENTEROLOGY : OFFICIAL JOURNAL OF THE DIGESTIVE DISEASES FOUNDATION 2006; 27:31-3. [PMID: 16910058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Endoscopic dilatation of achalasia cardia is an effective nonsurgical management option. It requires costly pneumatic dilators which are used under fluoroscopic guidance. This study assesses the efficacy and safety of an indigenous pneumatic dilator used without fluoroscopic guidance. METHODS Over a period of eleven years, 113 patients (69M, 44F) ofachalasia cardia underwent dilatation with indigenous pneumatic dilators without fluoroscopic guidance. The dilatation was performed under endoscopic vision. RESULTS The procedure was successful in all patients. After six weeks following dilatation, there was significant improvement in the mean dysphagia score 3.63 + 0.61 to 0.53 + 0.93 (P<0.01). The response was still significant (0.78 + 1.03, P <0.05) at the end of one year. Excellent response with single dilatation was seen in 70.7% patients. After two dilatation sessions 92% of patients showed an excellent response. One patient had perforation. There was no mortality. CONCLUSION Pneumatic dilatation under endoscopic vision without fluoroscopic assistance with the indigenous dilator is very effective and safe for short term treatment of achalasia carida.
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221
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Bauer E, Belkhou R, Cherifi S, Hertel R, Heun S, Locatelli A, Pavlovska A, Zdyb R, Agarwal N, Wang H. Microscopy of mesoscopic ferromagnetic systems with slow electrons. SURF INTERFACE ANAL 2006. [DOI: 10.1002/sia.2430] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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222
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Agarwal S, Sharma MC, Aron M, Sarkar C, Agarwal N, Chumber S. Poorly differentiated thyroid carcinoma with rhabdoid phenotype: a diagnostic dilemma--report of a rare case. Endocr Pathol 2006; 17:399-405. [PMID: 17525488 DOI: 10.1007/s12022-006-0011-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/1999] [Revised: 11/30/1999] [Accepted: 11/30/1999] [Indexed: 11/27/2022]
Abstract
Rhabdoid tumor is a distinct entity reported in renal and extrarenal sites. Malignant tumors of various types may have rhabdoid phenotype. There are eight case reports of carcinomas of thyroid with rhabdoid phenotype. All of these cases, except two, have been reported in middle-aged women (42-72 yr) and have had an aggressive clinical course with death occurring within few months to 4 yr after diagnosis. We report a case of poorly differentiated carcinoma of the thyroid with rhabdoid phenotype in a 22-yr-old male. The rhabdoid cells were immunopositive for thyroid transcription factor-1, vimentin, epithelial membrane antigen, and focally for cytokeratin. Synaptophysin, chromogranin, thyroglobulin, carcinoembryonic antigen, smooth muscle actin, myogenin, and desmin were all negative. To the best of our knowledge this is the ninth case report of carcinoma of the thyroid with rhabdoid phenotype. This case, unlike the previous reported cases, has certain unusual features including presentation in a young male, the absence of either follicular/papillary differentiation, and immunohistochemical profile of the rhabdoid cells.
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223
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Sharma S, Surya M, Kumar SGG, Negi A, Agarwal N. Radiological quiz - neuroradiology. Indian J Radiol Imaging 2006. [DOI: 10.4103/0971-3026.32405] [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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224
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Sharma S, Agarwal N, Negi A, Makhaik S. Imaging features of carcinoma of male urethra. Indian J Radiol Imaging 2006. [DOI: 10.4103/0971-3026.32380] [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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225
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Ramaswami N, Chaudhary LC, Agarwal N, Kamra DN. Effect of Lactic Acid Producing Bacteria on the Performance of Male Crossbred Calves Fed Roughage Based Diet. ASIAN-AUSTRALASIAN JOURNAL OF ANIMAL SCIENCES 2005. [DOI: 10.5713/ajas.2005.1110] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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226
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Arya SC, Agarwal N. Vaccinated but not immunized: healthcare personnel in developing countries. J Hosp Infect 2005; 60:290-1. [PMID: 15949624 DOI: 10.1016/j.jhin.2004.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2004] [Accepted: 12/15/2004] [Indexed: 10/25/2022]
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227
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Sharma BC, Kumar R, Agarwal N, Sarin SK. Endoscopic biliary drainage by nasobiliary drain or by stent placement in patients with acute cholangitis. Endoscopy 2005; 37:439-43. [PMID: 15844022 DOI: 10.1055/s-2005-861054] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND STUDY AIMS Endoscopic biliary drainage is an established mode of treatment for acute cholangitis. We compared the safety and efficacy of nasobiliary drain (NBD) placement and stent placement for biliary drainage in patients with acute cholangitis. PATIENTS AND METHODS We recruited a total of 150 patients with severe cholangitis who required endoscopic biliary drainage. Patients were randomized to have either a 7-Fr NBD or a 7-Fr straight flap stent placed during endoscopy. Outcome measures included complications related to endoscopic retrograde cholangiopancreatography (ERCP) and the clinical outcome. RESULTS Of the 150 patients, 75 were randomized to the NBD group and 75 to the stent group. The most common causes of biliary obstruction were common bile duct stones (n = 102) and biliopancreatic malignancies (n = 37). The site of the biliary obstruction was predominantly found to be the lower part of common bile duct in both the NBD group (n = 58) and the stent group (n = 59). Indications for biliary drainage were: a fever of > 100.4 degrees F (n = 140), hypotension (n = 23), peritonism (n = 40), impaired consciousness (n = 29), and failure to improve with conservative management (n = 45). Biliary drainage was achieved in 147 patients. Abdominal pain, fever, jaundice, hypotension, peritonism and altered sensorium improved after a median period of 2 days in both groups. Leukocyte counts became normal after a median time of 7 days in the NBD group and 6 days in the stent group. There were no ERCP-related complications. There were no instances of displacement or kinking of an NBD, occlusion of an NBD or stent, or of stent migration. Four patients died (two in the NBD group and two in the stent group) as a result of uncontrolled cholangitis after 1, 2, 4, and 6 days of biliary drainage. The success rates of biliary drainage in cholangitis were not affected by the type of endoprosthesis used (72/74 for NBD patients vs. 71/73 for stent patients), the etiology of the biliary obstruction (110/112 for benign obstruction vs. 33/35 for malignant obstruction), or the site of the biliary obstruction (28/30 for upper common bile duct obstruction vs. 115/117 for obstruction at the lower end of common bile duct). CONCLUSIONS Biliary drainage by nasobiliary drain and drainage by stent are equally safe and effective treatments for patients with severe cholangitis.
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Nijhawan S, Kumar D, Joshi A, Shende A, Agarwal N, Mathur A, Rai RR. Endoscopic band ligation for non variceal bleed. Indian J Gastroenterol 2005; 23:186-7. [PMID: 15599005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Endoscopic band ligation (EBL) is an infrequently used modality for treatment of non-variceal hemorrhage. We report the successful use of this technique for the management of bleed from blue rubber bleb nevus syndrome lesions and post polypectomy bleeding stalk.
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Nijhawan S, Joshi A, Shende A, Agarwal N, Kumar D, Mathur A, Rai R. Endoscopy-assisted ferromagnetic foreign-body removal with a novel magnetic instrument. Endoscopy 2004; 36:1130. [PMID: 15578313 DOI: 10.1055/s-2004-825980] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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230
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Arya SC, Agarwal N. Rubella immunity and immunization of male hospital personnel. J Hosp Infect 2004; 58:306-7. [PMID: 15564008 DOI: 10.1016/j.jhin.2004.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2004] [Indexed: 11/30/2022]
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231
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Arya SC, Agarwal N, Agarwal S, George S, Singh K. Nosocomial infection: hospital infection surveillance and control. J Hosp Infect 2004; 58:242-3. [PMID: 15501345 DOI: 10.1016/j.jhin.2004.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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232
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Arya SC, Kapoor S, Agarwal N, Bhasin R, George S. Comments on use of a disk diffusion method with cefoxitin (30 microg) to detect methicillin-resistant Staphylococcus aureus. Eur J Clin Microbiol Infect Dis 2004; 23:867-8. [PMID: 15490292 DOI: 10.1007/s10096-004-1232-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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233
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Arya SC, Agarwal N. Immunoprophylaxis or acyclovir prophylaxis against hospital-acquired varicella. J Hosp Infect 2004; 58:92-3. [PMID: 15350725 DOI: 10.1016/j.jhin.2004.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2004] [Indexed: 11/26/2022]
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Abstract
BACKGROUND The biochemical markers of a biliary etiology of acute pancreatitis (AP) include an ALT elevation of more than 3 times the upper range of normal (ULN) and a serum total bilirubin greater than 3 mg%. OBJECTIVES To analyze the frequency of normal LFTs (Bilirubin, ALP, ALT, and AST) in patients with biliary AP. DESIGN In this prospective study data collected for other ongoing studies on AP in the division of Gastroenterology in the last 20 years were analyzed. MATERIAL AND METHODS Serum total Bilirubin, AST, ALT, and ALP levels in 269 patients with biliary AP out of 728 cases of AP of various etiologies were analyzed. The biliary etiology was confirmed on the basis of gallstones documented by transabdominal US or at surgery. RESULTS We noted normal bilirubin, AST, ALT, and ALP levels in 14.5%, 12.3%, 11.2%, and 26.4% of cases of acute biliary pancreatitis respectively. When all the 4 laboratory tests were considered collectively, the incidence of normal values was 10.4%. We also noted an ALT elevation of <3 x ULN in 16.7% of cases of biliary AP and 43.5% of cases had a T. Bilirubin level of less than 3 mg %. CONCLUSIONS Almost 15 to 20% of patients with biliary AP manifest with normal LFTs. The clinician should not exclude a biliary etiology solely on the basis of normal LFTs.
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Chaudhari L, Tandon OP, Vaney N, Agarwal N. Lipid peroxidation and antioxidant enzymes in gestational diabetics. INDIAN JOURNAL OF PHYSIOLOGY AND PHARMACOLOGY 2003; 47:441-6. [PMID: 15266957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
The exact pro-oxidant and antioxidant status in gestational diabetes is still unclear. To add new insight to the question, changes in the lipid peroxidation products (MDA) and activities of antioxidant enzymes: superoxide dismutase (SOD) and catalase in red blood cell hemolysates were evaluated in 20 women with gestational diabetes. 20 healthy pregnant women served as the control group. Statistical analysis was done using unpaired Student' t - test. Pregnant women with gestational diabetes showed an increase in lipoperoxidation products (P < 0.001) and a decrease in SOD activity (P < 0.01) as compared to normal pregnant women while no significant change was observed in catalase activity. These findings suggest increased oxidative stress and decreased detoxification or free radical scavenging capacity in pregnancy complicated by diabetes.
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Bhatla N, Lal S, Behera G, Kriplani A, Mittal S, Agarwal N, Talwar KK. Cardiac disease in pregnancy. Int J Gynaecol Obstet 2003; 82:153-9. [PMID: 12873775 DOI: 10.1016/s0020-7292(03)00159-0] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To evaluate the maternal and fetal outcome of pregnancies complicated by cardiac disease in a developing country. METHODS A retrospective analysis was carried out of 207 pregnancies in women with cardiac disease who delivered at >or=28 weeks of gestation from June 1994 through December 2000 at a tertiary care center. RESULTS Rheumatic heart disease (n=183, 88%) with isolated mitral stenosis (n=71) was the predominant cardiac problem. Septal defects were the most common form of congenital heart disease (n=24). In 28 (13.52%) women, the diagnosis of cardiac disease was made during pregnancy. Cardiac complications were noted in 62 (29.95%) and fetal complications in 42 (20.28%) pregnancies. Patients in NYHA class I/II (n=175, 84.54%) had fewer maternal complications and their babies had a higher birth weight than those in NYHA class III/IV (n=32, 15.45%). Cardiac intervention was performed prior to pregnancy in 111 (60.65%) patients with rheumatic heart disease: PTMC/CMV in 73 and valve replacement (VR) in 38. Maternal and fetal outcome was better in patients with prosthetic valves (n=38) and the majority (97.4%) of them remained in NYHA class I/II. Cardiac intervention was safely carried out during pregnancy in 10 women (PTMC in 7, CMV in l, and VR in 2). One of them developed congestive cardiac failure during labor. None of the newborns of the 41 women who had received anticoagulants had any congenital malformation. CONCLUSIONS Rheumatic heart disease was the predominant type. Patients in NYHA class I/II had a better maternal and fetal outcome than those in NYHA class III/IV. Surgical correction of the cardiac lesion prior to pregnancy was associated with better pregnancy outcome. Pregnant women with prosthetic valves tolerated pregnancy well.
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MESH Headings
- Adolescent
- Adult
- Cardiovascular Agents/therapeutic use
- Female
- Heart Defects, Congenital/therapy
- Heart Diseases/diagnosis
- Heart Diseases/drug therapy
- Heart Diseases/epidemiology
- Heart Diseases/surgery
- Heart Diseases/therapy
- Heart Valve Prosthesis
- Humans
- India/epidemiology
- Infant, Low Birth Weight
- Infant, Newborn
- Labor, Obstetric
- Pregnancy
- Pregnancy Complications, Cardiovascular/diagnosis
- Pregnancy Complications, Cardiovascular/drug therapy
- Pregnancy Complications, Cardiovascular/epidemiology
- Pregnancy Complications, Cardiovascular/surgery
- Pregnancy Complications, Cardiovascular/therapy
- Pregnancy Outcome
- Pregnancy, High-Risk
- Retrospective Studies
- Rheumatic Heart Disease/therapy
- Risk Assessment
- Severity of Illness Index
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238
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Gupta AK, Agarwal N, Yadava RK, Jain SK. Quadriparesis in a young female suffering from rheumatoid arthritis. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2003; 51:734-5. [PMID: 14621052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Cervical spine is involved in a significant proportion of patients suffering from rheumatoid arthritis. Although cervical spine disease may often be 'benign', neurological complications are not uncommon. Patients of rheumatoid arthritis should be screened for cervical spine involvement and appropriately treated with combination of anti-rheumatic drugs. We report a case of quadriparesis secondary to subluxation and disc herniation at C4-C5 level in a young woman with rheumatoid arthritis of short duration.
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Nijhawan S, Joshi A, Kumar D, Shende A, Agarwal N, Mathur A, Rai RR. Barotrauma: a cause of hemobilia. Indian J Gastroenterol 2003; 22:112. [PMID: 12839394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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240
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Chaudhari L, Tandon OP, Vaney N, Agarwal N. Auditory evoked responses in gestational diabetics. INDIAN JOURNAL OF PHYSIOLOGY AND PHARMACOLOGY 2003; 47:75-80. [PMID: 12708127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
Electrophysiological correlates of sensory function in diabetic pregnancy have not been documented. Present study reports changes in Auditory evoked responses (AER) in gestational diabetics when compared with normal pregnant controls. Human AER are generally classified into early Auditory brainstem responses (AER), Mid latency responses (MLR) and late Slow vertex responses (SVR). These potentials were recorded in 20 women with diabetic pregnancy using Ag/AgCl electrodes from Cz-A1 and Cz-A2 position on MEB 5200 Neuropack II ... plus (Nihon Kohden, Japan) Evoked Potential Recorder. The evoked potentials in gestational diabetics were compared with 20 age matched normal pregnant women using Student's t-test. Absolute latencies of waves I to V, Inter peak latencies I-III and I-V of ABR were significantly increased whereas amplitude of wave V decreased in diabetic pregnant women. No significant change in latency of any component of MLR was observed between the two groups whereas significant prolongation of latencies of all components of SVR was observed in diabetic pregnant women as compared to normal control group. These findings indicate prolongation of both peripheral transmission time (PTT) and central transmission time (CTT) in diabetic pregnant females. Prolongation of latencies of SVR components in this study implicates cortex in the central diabetic neuropathy in women with gestational diabetes.
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241
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Jain SK, Gupta AK, Agarwal N. Wallenberg's lateral medullary syndrome. Postgrad Med J 2002; 78:618. [PMID: 12415087 PMCID: PMC1742528 DOI: 10.1136/pmj.78.924.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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242
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Agarwal N, Kamra DN, Chaudhary LC, Agarwal I, Sahoo A, Pathak NN. Microbial status and rumen enzyme profile of crossbred calves fed on different microbial feed additives. Lett Appl Microbiol 2002; 34:329-36. [PMID: 11967054 DOI: 10.1046/j.1472-765x.2002.01092.x] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To test various microbial cultures as cattle feed additives. METHODS AND RESULTS Four groups of newly born crossbred calves (average body weight 23.5 kg) were reared on green berseem and calf starter which was devoid of cereal grains. Milk was fed up to 8 weeks of age, starting with one tenths and gradually reducing to one twentieths of the body weight. One hundred millilitres of microbial feed additive or 100 g fermented feed was fed to the animals of group 2 (curd containing lactic acid bacteria at 10(8) cfu x ml(-1)), group 3 (Saccharomyces cerevisiae NCDC-49 at 10(6) cfu x ml(-1)) and group 4 (Lactobacillus acidophilus-15 at 10(8) cfu x ml(-1)). Group 1 served as control. The incidence and duration of diarrhoea was lower in the animals of probiotic fed groups as compared to control group. Out of three microbial feed additives, yeast feeding showed maximum suppression of diarrhoea followed by Lactobacillus and curd. CONCLUSIONS, SIGNIFICANCE AND IMPACT OF THE STUDY There was no effect of probiotic feeding on the log number of cells of lactic acid bacteria, yeast and coliform bacteria in the faeces and rumen liquor at any age. The activities of carboxymethylcellulase, xylanase, beta-glucosidase, alpha-glucosidase, alpha-amylase, protease, urease and pH of the rumen liquor remained unaffected by probiotic feeding at all ages tested in this experiment.
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Kriplani A, Agarwal N, Parul D, Bhatla N, Saxena AK. Prolapsed leiomyoma with severe haemorrhage after GnRH analogue therapy. J OBSTET GYNAECOL 2002; 22:449-51. [PMID: 12521484 DOI: 10.1080/014436102320261221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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244
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Agarwal N, Kriplani A, Vijayaraghavan M. Placental site trophoblastic tumour. J Postgrad Med 2002; 48:211-2. [PMID: 12432200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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245
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Agarwal N, Cherascu B. Concomitant acral necrosis and haemolytic uraemic syndrome following ingestion of quinine. J Postgrad Med 2002; 48:197-8. [PMID: 12432194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
Abstract
Thrombotic microangiopathy, which broadly includes thrombotic thrombocytopaenic purpura (TTP) and haemolytic uraemic syndrome (HUS), is a multisystemic disorder that is characterised by thrombocytopaenia, microangiopathic haemolytic anemia and ischaemic manifestations, resulting from platelet agglutination in the arterial microvasculature. Acral necrosis (distal necrosis of fingers and toes) occurs usually as a sequel to severe Raynaud's phenomenon, a vasculospastic disorder frequently related to endothelial cell dysfunction. We report a case of quinine induced TTP-HUS and acral necrosis, two distinct clinical abnormalities which have not yet been reported together in association with quinine. Both of these conditions in this case resolved promptly to treatment with corticosteroids.
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Abstract
An ideal laboratory test in the evaluation of a patient with acute pancreatitis (AP) should, in addition to accurately establishing the diagnosis of AP, provide early assessment of its severity and identify the etiology. None of the tests available today meet all these criteria, and presently there is no biochemical test that can be considered the "gold standard" for the diagnosis and assessment of severity of AP. In the diagnosis of AP, serum amylase and lipase remain important tests. Advantages of amylase estimation are its technical simplicity, easy availability, and high sensitivity. However, its greatest disadvantage is its low specificity. A normal amylase would usually exclude the diagnosis of AP, with the exception of AP secondary to hyperlipidemia, acute exacerbation of chronic pancreatitis, and when the estimation of amylase is delayed in the course of the disease. The major advantage of lipase is an increased sensitivity in acute alcoholic pancreatitis and in patients who initially present to the emergency room days after the onset of the disease, as lipase remains elevated longer than amylase. Although once considered to be specific for AP, nonspecific elevations of lipase have been reported in almost as many disorders as amylase, thus decreasing its specificity. Simultaneous estimation of amylase and lipase does not improve the accuracy. Other enzymes for the diagnosis of AP--pancreatic isoamylase, immunoreactive trypsin, and elastase--are more cumbersome and expensive and have no clear role in the diagnosis of AP. No enzyme assay has a predictive role in determining the severity or etiology of AP. Once the diagnosis of AP is established, daily measurements of enzymes have no value in assessing the clinical progress of the patient or ultimate prognosis and should be discouraged. A host of new serological and urinary markers have been investigated in the last few years. Their main use is in predicting the severity of AP. At present, serum C-reactive protein at 48 h is the best available laboratory marker of severity. Urinary trypsinogen activation peptides within 12-24 h of onset of AP are able to predict the severity but are not widely available. Serum interleukins 6 and 8 seem promising but remain experimental.
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Gomber S, Agarwal KN, Mahajan C, Agarwal N. Impact of daily versus weekly hematinic supplementation on anemia in pregnant women. Indian Pediatr 2002; 39:339-46. [PMID: 11976463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
OBJECTIVE To compare the effectivity of weekly versus daily iron therapy in reducing maternal anemia and to evaluate the association of maternal hemoglobin and fetal growth. DESIGN Prospective. SETTING Tertiary care teaching hospital in an urban metropolis. METHOD 40 pregnant women received daily and 40 pregnant women received weekly oral therapy (335 mg of ferrous sulphate and 500 g folic acid) for a period of 14 weeks. The age of each pregnant woman and their baseline anthropometric data (weight, height and body mass index) were estimated. Hemoglobin and hematocrit estimations were carried out during follow period at 4 wks, 8 wks and 14 weeks. Serum ferritin values as a marker of iron status were also calculated in both the groups initially, at 14 weeks and at the time of delivery. Fetal anthropometric indices of 137 full term neonates delivered to mothers included in either of the supplementation groups or admitted to the hospital were also studied in relation to maternal hemoglobin concentration. RESULTS Forty subjects each were initially randomized into groups I and II. The age of pregnant women along with their baseline anthropometric data were similar in both groups. A total of 29 pregnant women in group I and 27 pregnant women in group II could be regularly followed up. The increase in hemoglobin and hematocrit values were similar in daily and weekly supplemented mothers. An intention to treat analysis also showed similar results. The ferritin values were similar at the start of supplementation and after 14 wks of weekly or daily iron therapy. Birth weight, crown heel length, head circumference of the neonate and placental weight increased significantly with rise in maternal hemoglobin levels. CONCLUSION Weekly iron supplementation is an effective mode of treating anemia among pregnant women and maternal anemia during pregnancy is adversely associated with fetal growth.
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248
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Radhakrisknan G, Vaid NB, Agarwal N. Rupture uterus--changing Indian scenario. JOURNAL OF THE INDIAN MEDICAL ASSOCIATION 2001; 99:634-7. [PMID: 12022205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
A total of 60 cases of rupture uterus managed in last five years in the department of obstetrics and gynaecology at the University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi were reviewed. Of these 77% cases reported to the hospital with rupture uterus while in 23% cases rupture occurred after admission. The factor responsible for rupture in admitted patients was either oxytocin induction/augmentation in scarred uterus or obstetrical manipulation in unscarred uterus; 80% cases were totally unsupervised during antenatal period. Previous uterine scar was responsible for rupture in as high as 63.3% cases. The commonest previous surgery was caesarean section mostly for non-recurrent causes. Obstructed labour was responsible for rupture in 26.6% cases while traumatic rupture was seen in 10% cases. Repair of uterine rent was performed in 54% cases while rest required hysterectomy. Bladder injury was associated in 9 cases and was repaired at the time of laparotomy. Maternal mortality was 3.33% and foetal mortality was 78.66%. The changing trends observed in the present study are those of low maternal mortality and decreasing incidence of obstructed labour in the aetiology of rupture uterus.
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Cushman JG, Agarwal N, Fabian TC, Garcia V, Nagy KK, Pasquale MD, Salotto AG. Practice management guidelines for the management of mild traumatic brain injury: the EAST practice management guidelines work group. THE JOURNAL OF TRAUMA 2001; 51:1016-26. [PMID: 11706358 DOI: 10.1097/00005373-200111000-00034] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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