1
|
Pandey V, Aier S, Agarwal S, Sandhu AS, Murali SD. Prevalence of prediabetes in patients with idiopathic frozen shoulder: a prospective study. JSES Int 2024; 8:85-89. [PMID: 38312298 PMCID: PMC10837728 DOI: 10.1016/j.jseint.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024] Open
Abstract
Background The association between diabetes and frozen shoulder is well established. However, the data regarding prediabetes and primary frozen shoulder (PFS) are still lacking. Methods In a prospective study, 158 patients with PFS were included. The prediabetes status was ascertained by estimating serum hemoglobin A1c (HbA1c) levels in patients with PFS. According to the level of HbA1c, patients were classified into normoglycemic, prediabetic, and diabetic. In addition, random blood sugar (RBS) was also performed. Results Out of 158 participants, 84 (53.2%) were male and 74 (46.8%) were female. Nine patients had bilateral shoulder involvement, and all were diabetics; 47.5% (n = 75) of the patients were in the age group of 51-60 years, 16.5% (n = 26) of the participants were normoglycemic, 37.3% (n = 59) were prediabetics, and 46.2% (n = 73) were diabetics. The difference in mean HbA1c values between the 3 groups was statistically significant (P < .001). However, there was no statistical difference in various age groups (P = .86) or gender (P = .68) between normoglycemics, prediabetics, and diabetics. The difference in mean RBS values between diabetic-nondiabetic and diabetic-prediabetic groups were statistically significant (P < .001), whereas no significant difference was detected between nondiabetic and prediabetic (P = .355). Conclusion The prevalence of prediabetes is 37.5% in patients with PFS. Single-point HbA1c estimation is an acceptable tool to detect prediabetes, whereas RBS estimation should not be used to detect prediabetes.
Collapse
Affiliation(s)
- Vivek Pandey
- Department of Orthopaedics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India
| | - Sashitejmen Aier
- Department of Orthopaedics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India
| | - Saksham Agarwal
- Department of Orthopaedics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India
| | - Avneet Singh Sandhu
- Department of Orthopaedics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India
| | - Sujayendra D. Murali
- Department of Orthopaedics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Karnataka, India
| |
Collapse
|
2
|
Coffey CM, Sandhu AS, Crowson CS, Asante D, Matteson EL, Osborn TG, Warrington KJ, Makol A. Outpatient healthcare utilization among incident cases of systemic sclerosis: results from a population-based US cohort (1988-2016). Scand J Rheumatol 2021; 51:323-328. [PMID: 34232106 DOI: 10.1080/03009742.2021.1932581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Systemic sclerosis (SSc) is a complex, heterogeneous connective tissue disease with multiorgan dysfunction. This study aimed to compare healthcare utilization among incident cases of SSc versus age- and gender-matched comparators. METHOD A population-based cohort of physician-diagnosed patients with SSc in Olmsted County, MN, USA, from 1 January 1988 to 31 December 2016 was assembled. A 2:1 cohort of age- and gender-matched non-SSc subjects was randomly selected for comparison. Patients were followed until death, migration from Olmsted County, or 31 December 2017. Outpatient utilization data were obtained beginning 12 months before the SSc incidence/index date and compared using negative binomial and multinomial models. Services were summarized as visit-days to avoid overestimation of services provided. RESULTS The study included 69 incident SSc cases and 138 non-SSc comparators (mean ± sd age 57 ± 16 years at diagnosis/index, 90% female). Patients with SSc had higher utilization of outpatient physician, laboratory, and combined radiology visit-days annually for the year before and for each of the first 5 years after diagnosis than comparators. Among patients with SSc, healthcare utilization was highest during the year of SSc diagnosis. Rate ratios comparing utilization in patients with and without SSc ranged from 1.8 to 3.0 for all comparisons. CONCLUSION Higher utilization of outpatient physician, laboratory, and radiology visit-days was observed among patients with SSc compared to non-SSc subjects throughout 5 years of disease duration, indicating high and continued care needs in this patient population. The highest utilization of services among SSc patients occurred during the year of SSc diagnosis.
Collapse
Affiliation(s)
- C M Coffey
- Division of Rheumatology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - A S Sandhu
- Department of Internal Medicine, Kettering Medical Center, Kettering, OH, USA
| | - C S Crowson
- Division of Rheumatology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.,Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - D Asante
- Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - E L Matteson
- Division of Rheumatology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.,Department of Health Sciences Research, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - T G Osborn
- Division of Rheumatology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - K J Warrington
- Division of Rheumatology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - A Makol
- Division of Rheumatology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| |
Collapse
|
3
|
Sandhu AS. Intestinal Prolapse Through Patent Omphalomesenteric Duct in a Neonate. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02486-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
4
|
Alotaibi AS, Sandhu AS, McIntosh K, Jairath V, Sey M. A114 AN UNUSUAL CASE OF BLOW-OUT PERFORATION OF A DEFUNCTIONED STOMACH POST ROUX-EN-Y GASTRIC BYPASS DUE TO CROHN’S DISEASE. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A S Alotaibi
- Department of Medicine, Western University , London, ON, Canada
| | - A S Sandhu
- Department of Medicine, Western University , London, ON, Canada
| | - K McIntosh
- Department of Medicine, Western University , London, ON, Canada
| | - V Jairath
- Department of Medicine, Western University , London, ON, Canada
| | - M Sey
- Department of Medicine, Western University , London, ON, Canada
| |
Collapse
|
5
|
Al Draiweesh S, Ma C, Alkhattabi M, McDonald C, Chande N, Feagan BG, Gregor JC, Khanna R, Marotta P, Sandhu AS, Qumosani K, Teriaky A, Brahmania M, Jairath V. A130 SAFETY OF COMBINATION BIOLOGIC AND ANTI-REJECTION THERAPY POST-LIVER TRANSPLANTATION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: LONDON ONTARIO EXPERIENCE. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- S Al Draiweesh
- Gastroenterology, Western University, London, ON, Canada
| | - C Ma
- Gastroenterology, Western University, London, ON, Canada
| | - M Alkhattabi
- Gastroenterology, Western University, London, ON, Canada
| | - C McDonald
- Gastroenterology, Western University, London, ON, Canada
| | - N Chande
- Gastroenterology, Western University, London, ON, Canada
| | - B G Feagan
- Gastroenterology, Western University, London, ON, Canada
| | - J C Gregor
- Gastroenterology, Western University, London, ON, Canada
| | - R Khanna
- Gastroenterology, Western University, London, ON, Canada
| | - P Marotta
- Gastroenterology, Western University, London, ON, Canada
| | - A S Sandhu
- Gastroenterology, Western University, London, ON, Canada
| | - K Qumosani
- Department of Medicine, Western Univesity, London, ON, Canada
| | - A Teriaky
- Gastroenterology, Western University, London, ON, Canada
| | - M Brahmania
- Gastroenterology, Western University, London, ON, Canada
| | - V Jairath
- Gastroenterology, Western University, London, ON, Canada
| |
Collapse
|
6
|
Dudani S, Malik A, Sandhu AS, Mani NS. Pseudohyperplastic variant of adenocarcinoma as a component of α-methyl-CoA-racemase (AMACR negative) carcinosarcoma of the prostate. Indian J Urol 2015; 31:136-8. [PMID: 25878416 PMCID: PMC4397551 DOI: 10.4103/0970-1591.152921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Carcinosarcoma (CS) or Sarcomatoid carcinoma (SC) of the prostate is a very rare malignant tumor of the prostate having an aggressive clinical course and dismal prognosis. The adenocarcinomatous element is usually of the acinar type and closely admixed with a sarcomatous component. We report a case of α-methyl–CoA-racemase (AMACR)-negative pseudohyperplastic variant of adenocarcinoma in CS. To the best of our knowledge, there have been no published case reports of this variant in CS till date. An accurate diagnosis is essential as this uncommon, aggressive cancer has limited therapeutic options
Collapse
Affiliation(s)
- Sharmila Dudani
- Department of Pathology, Army College of Medical Sciences and Base Hospital, Delhi Cantt, Delhi, India
| | - Ajay Malik
- Department of Pathology, Army College of Medical Sciences and Base Hospital, Delhi Cantt, Delhi, India
| | - A S Sandhu
- Department of Urology, Army College of Medical Sciences and Base Hospital, Delhi Cantt, Delhi, India
| | - N S Mani
- Department of Pathology, Army College of Medical Sciences and Base Hospital, Delhi Cantt, Delhi, India
| |
Collapse
|
7
|
Piplani S, Kapur BN, Sandhu AS, Dhagat PK, Kakkar S, Singh S, Bhatoe HS. Bilateral hybrid oncocytoma and renal cell carcinoma. J Assoc Physicians India 2012; 60:47-50. [PMID: 23409424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A 26-year-old female presented with abdominal pain and distension in 2003. Clinical evaluation and imaging were suggestive of bilateral benign renal solid masses. Fine needle aspiration showed tubular cells only. Patient was kept under periodic follow up. She reported 4 years later with increase in pain and size of masses, and underwent bilateral staged nephron sparing surgery. The histopathology was reported as bilateral oncocytoma. Two years after surgery, she developed epidural spinal cord compression and liver metastasis. A decompression laminectomy and biopsy revealed conventional renal cell carcinoma (RCC). To our knowledge this is the first case report of sporadic bilateral synchronous hybrid RCC and oncocytoma in a young woman, with spinal epidural metastasis.
Collapse
Affiliation(s)
- S Piplani
- Department of Medical Oncology, Malignant Diseases Treatment Center, Command Hospital, Pune
| | | | | | | | | | | | | |
Collapse
|
8
|
Sandhu AS, Srivastava A, Madhusoodanan P, Sinha T, Gupta SK, Kumar A, Sethi GS, Khanna R. Holmium : YAG Laser for Intra Corporeal Lithotripsy. Med J Armed Forces India 2011; 63:48-51. [PMID: 27407938 DOI: 10.1016/s0377-1237(07)80109-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2004] [Accepted: 03/12/2005] [Indexed: 11/16/2022] Open
Affiliation(s)
- A S Sandhu
- Classified Specialist (Surgery & Urology), Command Hospital (Southern Command), Armed Forces Medical College, Pune
| | - A Srivastava
- Classified Specialist (Surgery & Urology), Command Hospital (Central Command), Armed Forces Medical College, Pune
| | | | - T Sinha
- Senior Advisor (Surgery & Urology), Army Hospital (R&R), Command Hospital (Southern Command), Pune 411 040
| | - S K Gupta
- Classified Specialist (Surgery & Urology), Command Hospital (Eastern Command), Command Hospital (Southern Command), Pune 411 040
| | - A Kumar
- Classified Specialist (Surgery & Urology), Command Hospital (AF), Command Hospital (Southern Command), Pune 411 040
| | - G S Sethi
- Classified Specialist (Surgery & Urology), Army Hospital (R&R), Command Hospital (Southern Command), Pune 411 040
| | - R Khanna
- Classified Specialist (Surgery & Urology), Command Hospital (Southern Command), Pune 411 040
| |
Collapse
|
9
|
Sandhu AS, Rao P, Arora S. Idiopathic Segmental Infarction of the Greater Omentum. Med J Armed Forces India 2009; 65:67-8. [PMID: 27408196 DOI: 10.1016/s0377-1237(09)80061-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2008] [Accepted: 08/29/2008] [Indexed: 10/18/2022] Open
Affiliation(s)
- A S Sandhu
- Senior Advisor (Surgery & Urology), Command Hospital (Southern Command), Pune- 411 040
| | - P Rao
- Prof & Head (Department of Surgery) Rural Institute of Medical Science & Research, Saifai, Dist: Etawah, UP- 206 301
| | - S Arora
- Senior Advisor (Pathology), 155 Base Hospital, C/o 99 APO
| |
Collapse
|
10
|
Abstract
Male andropause, male climacteric or viropause is a condition in which men suffer from complex symptomatology due to low androgen level with aging. After the age of 40 years testosterone level starts declining and andropause corresponds to the age at which a pathogenic threshold is reached. This review summarizes the etiology, consequences, screening, diagnosis, monitoring of androgen deficiency in aging male (ADAM). The pros and cons of testosterone replacement therapy (TRT) in elderly male have been discussed. Currently oral, transdermal, transbuccal, intramuscular, and subcutaneous implants are available for clinical use. The choice is made by physicians based on therapeutic indication and patient preferences.
Collapse
Affiliation(s)
- PR Nandy
- Classified Specialist (Surgery & Urology), Command Hospital (Southern Command), Pune
| | - DV Singh
- Senior Advisor (Surgery & Urology), Base Hospital, Delhi Cantt
| | | | - AS Sandhu
- Senior Advisor (Surgery & Urology), Command Hospital (Southern Command), Pune
| |
Collapse
|
11
|
Baliga KV, Narula AS, Sharma A, Khanduja R, Manrai M, Debnath J, Sandhu AS. Successful medical treatment of emphysematous pyelonephritis in a renal allograft recipient. Ren Fail 2007; 29:755-8. [PMID: 17763174 DOI: 10.1080/08860220701460434] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Emphysematous pyelonephritis in renal allograft recipients is a rare but serious complication. The management of this entity is a subject of controversy in live related donor programs where the absence of a second donor is a key factor influencing surgical removal of the graft. We present a case of emphysematous pyelonephritis in a renal allograft recipient managed successfully with medical therapy alone.
Collapse
Affiliation(s)
- K V Baliga
- Department of Nephrology, Command Hospital (Southern Command), Pune, Maharashtra, India.
| | | | | | | | | | | | | |
Collapse
|
12
|
Srivastava A, Sandhu AS, Sinha T, Madhusoodanan P, Karan SC, Sethi GS, Talwar R, Narang V. Intravesical Explosion during Transurethral Resection of Prostate - a reminder. Urol Int 2006; 77:92-3. [PMID: 16825825 DOI: 10.1159/000092944] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2005] [Accepted: 09/27/2005] [Indexed: 12/18/2022]
Abstract
Intravesical explosion during transurethral resection of the prostate (TURP) is an extremely rare but dreaded complication and results in rupture of the bladder. It is believed that intravesical explosion occurs due to formation of explosive gases in the bladder during TURP and its admixture with air. A case of intravesical explosion during TURP resulting in bladder rupture at our institution is described. Though the management of this catastrophe is relatively straightforward, it has the potential for dire consequences. We emphasize that, despite its rare occurrence, it is preventable and suggest measures to avoid it.
Collapse
Affiliation(s)
- Anand Srivastava
- Department of Urology, Army Hospital (Research and Referral), Delhi Cantt, New Delhi, India.
| | | | | | | | | | | | | | | |
Collapse
|
13
|
Srivastava A, Sinha T, Madhusoodanan P, Karan SC, Sandhu AS, Sethi GS, Kotwal SV, Bhatyal HS, Sood R, Gupta SK, Verma PP. Urological complications of live related donor renal transplantation: 13 years' experience at a single center. Urol Int 2006; 77:42-5. [PMID: 16825814 DOI: 10.1159/000092933] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2005] [Accepted: 01/05/2006] [Indexed: 01/11/2023]
Abstract
BACKGROUND This study is a retrospective analysis of urological complications and their treatment in our series of live-donor renal transplantation. MATERIAL AND METHODS The series comprised of 500 patients. All underwent extravesical ureteroneocystostomy and all except a few initial patients were stented. RESULTS There were 92 complications in 82 patients (18.4%). Urinary leakage occurred in 1.2%. There were no intrinsic ureteric obstructions. Extrinsic ureteric obstruction occurred in 0.8% of cases. The incidence of UTI was 15.4% and of urethral strictures 1%. CONCLUSION The technique of stented extravesical ureteroneocystomy has led to an extremely low rate of urological complications in our series, over a long time and in a substantial number of patients.
Collapse
Affiliation(s)
- Anand Srivastava
- Department of Urology, Army Hospital (Research and Referral), Delhi Cantt, Delhi, India.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Sinha T, Varma PP, Srivastava A, Karan SC, Sandhu AS, Sethi GS, Khanna R, Talwar R, Narang V. A Comparative Study of Laparoscopic with Conventional Open Donor Nephrectomy in Renal Transplantation. Med J Armed Forces India 2006; 62:236-8. [PMID: 27365685 DOI: 10.1016/s0377-1237(06)80009-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2005] [Accepted: 10/06/2005] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Laparoscopic donor nephrectomy (LDN) has been gaining popularity among kidney donors. There have been concerns about the safety and efficacy of the procedure as compared to open donor nephrectomy (ODN). We compare our results on LDN with ODN. METHODS We retrospectively analysed our data of LDN and ODN. Duration of surgery, blood loss, period of hospitalisation, per oral intake and analgesic requirements. RESULT 22 LDNs were done, the operation time ranged from 220-300 minutes, and blood loss from 100-150ml. In the first 10 laparoscopic operations four cases required conversion to open surgical dissection. Only one case was converted to open surgery in the subsequent 12 laparoscopic cases. Oral intake was started on the first postoperative day. Analgesic requirement in laparoscopy cases was less. Patients were mobilised on the first day after surgery. Patients were discharged by seventh day. There was no significant difference in the functioning of the graft after revascularisation in the recipient. CONCLUSION Laparoscopic donor nephrectomy is a safe and effective technique of donor nephrectomy.
Collapse
Affiliation(s)
- T Sinha
- Senior Advisor and Head of Dept, Delhi Cantt
| | - P P Varma
- Senior Advisor (Medicine and Nephrology) Army Hospital (R&R), Delhi Cantt
| | - A Srivastava
- Graded Specialist (Surgery), Army Hosp (R&R), Delhi Cantt
| | - S C Karan
- Senior Advisor (Surgery and Urology), AH(R&R), Delhi Cantt
| | - A S Sandhu
- Classified Specialist (Surgery and Urology), AH (R&R), Delhi Cantt
| | - G S Sethi
- Classified Specialist (Surgery and Urology), AH (R&R), Delhi Cantt
| | - R Khanna
- Classified Specialist (Surg), CH (SC) Pune
| | - R Talwar
- Classified Specialist (Surg), CH (SC) Pune
| | - V Narang
- Resident (Urology), AH (R&R), Delhi Cantt
| |
Collapse
|
15
|
Srivastava A, Sinha T, Karan SC, Sandhu AS, Sethi GS, Talwar R, Narang V. Dispelling inhibition for laparoscopic surgery in younger children with Cushing's syndrome. Case report and literature review. Urol Int 2006; 76:283-4. [PMID: 16601396 DOI: 10.1159/000091636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2005] [Accepted: 08/04/2005] [Indexed: 11/19/2022]
Abstract
Laparoscopic adrenalectomy (LA) is now the gold standard for the treatment of small, benign adrenal tumors in adults. In Cushing's syndrome (CS), LA is difficult and seldom done, especially in younger children. A 6-year-old girl was diagnosed with CS due to a juxtaadrenal tumor. She underwent LA and made an uneventful recovery. The histopathology was reported as paraganglioma which is a very rare cause of CS. LA is seldom done in younger children with CS owing to extreme obesity, abundant perinephric fat and a high incidence of pre- and postoperative complications.
Collapse
Affiliation(s)
- Anand Srivastava
- Department of Urology, Army Hospital (Research & Referral), New Delhi, India.
| | | | | | | | | | | | | |
Collapse
|
16
|
Sandhu AS, Ravindra Kumar G, Sengupta S, Das A, Kaw PK. Real-time study of fast-electron transport inside dense hot plasmas. Phys Rev E Stat Nonlin Soft Matter Phys 2006; 73:036409. [PMID: 16605670 DOI: 10.1103/physreve.73.036409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2005] [Indexed: 05/08/2023]
Abstract
We offer a method to study transport of fast electrons in dense hot media. The technique relies on temporal profiling of the laser induced magnetic fields and offers a unique capability to map the hot electron currents and their neutralization (or lack of it) by the return currents in the plasma. We report direct quantitative measurements of strong electric inhibition in insulators and turbulence induced anomalous stopping of hot electrons in conductors. The present technique can prove extremely important from the point of view of fast ignition scheme, which relies on the penetration of fast electrons into the fusion core.
Collapse
Affiliation(s)
- A S Sandhu
- Tata Institute of Fundamental Research, 1 Homi Bhabha Road, Mumbai 400005, India
| | | | | | | | | |
Collapse
|
17
|
Srivastava A, Sinha T, Karan SC, Sandhu AS, Gupta SK, Sethi GS, Talwar R, Narang V, Adlakha N, Agarwal A. Assessing the efficiency of extracorporeal shockwave lithotripsy for stones in renal units with impaired function: a prospective controlled study. ACTA ACUST UNITED AC 2006; 34:283-7. [PMID: 16479390 DOI: 10.1007/s00240-006-0046-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2005] [Accepted: 01/27/2006] [Indexed: 10/25/2022]
Abstract
The objective was to determine the efficiency of extracorporeal shockwave lithotripsy (ESWL) in clearing stones from renal units with impaired function. Thirty-five patients with poorly functioning kidneys determined by intravenous urogram and 99mtechnetium diethylene triamine pentacetic acid renal dynamic scan underwent ESWL. Stone clearance was assessed at 3 months and compared with that in normally functioning kidneys. The study group was divided into two subgroups. Those with split glomerular filtration rate (GFR) of the concerned kidney between 10 and 20 ml/min were in group 1. Group 2 consisted of patients with split GFR between 20 and 30 ml/min. A control group (group 3) was formed from patients with urolithiasis and normally functioning kidneys. The overall retreatment rate was 84.4%. The overall stone clearance rate in the study group was 34.2% while it was 57.7% in the control group. The stone clearance rate in group 2 was 40%. The difference in stone clearance rate between the study and control groups was statistically significant (P=0.023) but that between group 2 and the control group was not (P=0.159). The incidence of steinstrasse between the study group 2 and control group was not statistically significant (P=0.408). The clearance rate for ureteral stones was comparable in all the three groups. The stone-free rate and rate of steinstrasse for renal stones in kidneys with moderately impaired function were comparable to normally functioning kidneys. However, kidneys with severely impaired function had poor results. The clearance rate for ureteral stones was not influenced by the impairment of renal function.
Collapse
Affiliation(s)
- Anand Srivastava
- Department of Urology, Army Hospital (Research & Referral), Delhi Cantt, 110010, Delhi, India.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Srivastava A, Sinha T, Varma PP, Karan SC, Sandhu AS, Sethi GS, Khanna R, Talwar R, Narang V. Experience with marginal living related kidney donors: Are they becoming routine or are there still any doubts? Urology 2005; 66:971-5. [PMID: 16286105 DOI: 10.1016/j.urology.2005.05.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2005] [Revised: 04/11/2005] [Accepted: 05/05/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To analyze donor and recipient outcome of grafts from marginal kidney donors (ie, elderly or suffering from some anomaly). METHODS We had 81 marginal donors from July 1996 to July 2004; 46 were older than 60 years, and 39 had renal or nonrenal anomaly. The donors and recipients were evaluated for morbidity, graft and recipient survival, and the number of rejection episodes. RESULTS The mean (+/- standard deviation) age of elderly donors was 62.2 +/- 3.1 years. Follow-up ranged from 6 months to 50 months (mean 21.15 +/- 0.9 months). Actuarial 1-year and 3-year graft survival rates were 95% and 81%, respectively. Twenty-six percent of recipients maintained serum creatinine levels less than 1.4 mg/dL. The mean age of hypertensive donors was 46.2 years, and blood pressure was controlled with one drug. Serum creatinine levels in the recipients were less than 1.4 mg/dL in 10 and less than 2.5 mg/dL in the rest. Eleven percent of hypertensive donors required an increase in their antihypertensive medication. All donors showed a 15% to 20% increase in their glomerular filtration rate. Donors underwent simultaneous surgery when indicated. CONCLUSIONS Criteria to reject donors need to be reviewed periodically. The elderly and donors with other anomalies are consistently showing acceptable results. Hypertensive donors require assessment with awake ambulatory blood pressure monitoring.
Collapse
Affiliation(s)
- Anand Srivastava
- Department of Urology, Army Hospital (Research & Referral), Delhi, India.
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Sandhu AS, Kumar GR, Sengupta S, Das A, Kaw PK. Laser-pulse-induced second-harmonic and hard x-ray emission: role of plasma-wave breaking. Phys Rev Lett 2005; 95:025005. [PMID: 16090694 DOI: 10.1103/physrevlett.95.025005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2004] [Indexed: 05/03/2023]
Abstract
We report time resolved measurements of second-harmonic and hard x rays emitted during the interaction of an intense laser pulse (10(16) W cm(-2), 100 fs) with a preplasma generated on a solid target. We observe that for a particular length scale the second harmonic goes through a minimum, while hard x-ray emission on the contrary maximizes. Theoretical or numerical modeling of this anticorrelation in terms of wave breaking of strongly driven electron plasma waves clearly brings out hitherto unexplored links between the physical mechanisms of second-harmonic generation and hard x-ray emission.
Collapse
Affiliation(s)
- A S Sandhu
- Tata Institute of Fundamental Research, 1 Homi Bhabha Road, Mumbai 400 005, India. arvinder@
| | | | | | | | | |
Collapse
|
20
|
Sandhu AS, Temple RH, Timms MS. Partial laser turbinectomy: two year outcomes in patients with allergic and non-allergic rhinitis. Rhinology 2004; 42:81-4. [PMID: 15224634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
OBJECTIVE The aim was to compare two year outcomes of partial laser turbinectomy in patients with allergic and non-allergic rhinitis with respect to nasal obstruction symptom scores and nasal peak inspiratory flow rates (nPIFR). This has not been reported previously. METHOD Fifty-four patients underwent partial laser turbinectomy (28 with allergic rhinitis, 26 with non-allergic rhinitis). NPIFR was measured preoperatively, at 3 months and two years postoperatively. A symptom score questionnaire was also completed. RESULTS Both allergic and non-allergic patients showed a significant improvement in symptom scores and nPIER at three months (n = 54). The improvement in allergic patients was greater. In the 31 patients seen at two years, there was still a significant improvement in median symptom scores but no such improvement in median nPIFR. In allergic patients (n = 18) at two years, there was no significant improvement in symptom and nPIFR scores. Non-allergic patients (n = 13), however, did show sustained significant improvement in these scores (p < 0.05). Eighty-seven percent (26/31) considered the operation successful and would recommend it to others. CONCLUSIONS Non-allergic patients derive a more sustained improvement in the medium term compared to allergic individuals when undergoing partial laser turbinectomy. The improvement in symptom scores in the group as a whole was still significant.
Collapse
Affiliation(s)
- A S Sandhu
- Department of Otorhinolaryngology, Blackburn Royal Infirmary, Blackburn, Lancashire BB2 3LR, England.
| | | | | |
Collapse
|
21
|
Pradhan AA, Sood R, Madhusoodanan P, Sandhu AS, Gupta SK, Kumar A. Endopyelotomy - a Minimally Invasive Surgical Option for Pelvi-ureteric Junction Obstruction: a Study Of 34 Cases. Med J Armed Forces India 2003; 59:320-3. [PMID: 27407554 PMCID: PMC4923617 DOI: 10.1016/s0377-1237(03)80145-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
We performed antegrade endopyelotomy in 34 cases in the last 2½ years. In all cases standardized antegrade percutaneous method was used. A single guide wire and a cold knife were used to perform the endopyelotomy. Nephrostomy tube was retained for 48 hours and the repair stented for 6 weeks. Patients were followed up at 3 months, 6 months and 1 year post-operatively for subjective improvement and objectively by DTPA scans/IVU and ultrasound. The population included 2 bilateral cases, one horseshoe kidney and 3 children. The patient's age ranged from 9-59 years, average 32 years. There were 21 males and 13 females. 28 renal units were primary and 8 were secondary pelviureteric junction (PUJ) obstruction. Follow up period was 3-28 months. Most cases had significant symptomatic and functional recovery postoperatively. Five cases presented with urinary tract infection, which regressed after treatment. At 3(rd) month postoperatively the DTPA/IVU scan was equivocal in 7 cases. In these, a RGP was done which in every case showed a patent PUJ. In 5 cases that were still symptomatic, 6-8 weeks of further stenting produced symptom regression. Two cases failed and needed revision, one by open pyeloplasty and the other by endopyelotomy. Our success rate overall in these cases followed upto 1 year post operatively is 91.6%. We conclude that endopyelotomy is successful across a wide spectrum of cases.
Collapse
Affiliation(s)
- A A Pradhan
- Graded Specialist (Surgery), Command Hospital (Central Command), Lucknow
| | - Rajeev Sood
- Classified Specialist (Surgery& Urology), Army Hospital (R & R), Delhi Cantt
| | - P Madhusoodanan
- Consultant (Surgery & Urology), Army Hospital (R & R), Delhi Cantt
| | - A S Sandhu
- Classified Specialist (Surgery& Urology), Army Hospital (R & R), Delhi Cantt
| | - S K Gupta
- Classified Specialist (Surgery), Military Hospital, Jaipur
| | - Anil Kumar
- Graded Specialist (Surgery), Military Hospital, Meerut
| |
Collapse
|
22
|
Rajeev PP, Taneja P, Ayyub P, Sandhu AS, Kumar GR. Metal nanoplasmas as bright sources of hard X-ray pulses. Phys Rev Lett 2003; 90:115002. [PMID: 12688936 DOI: 10.1103/physrevlett.90.115002] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2002] [Indexed: 05/24/2023]
Abstract
We report significant enhancements in light coupling to intense-laser-created solid plasmas via surface plasmon and "lightning rod" effects. We demonstrate this in metal nanoparticle-coated solid targets irradiated with 100 fs, 806 nm laser pulses, focused to intensities approximately 10(14)-10(15) W cm(-2). Our experiments show a 13-fold enhancement in hard x-ray yield (10-200 keV) emitted by copper nanoparticle plasmas formed at the focal volume. A simple model explains the observed enhancement quantitatively and provides pointers to the design of structured surfaces for maximizing such emissions.
Collapse
Affiliation(s)
- P P Rajeev
- Tata Institute of Fundamental Research, 1, Homi Bhabha Road, Mumbai 400 005, India
| | | | | | | | | |
Collapse
|
23
|
Sandhu AS, Dharmadhikari AK, Rajeev PP, Kumar GR, Sengupta S, Das A, Kaw PK. Laser-generated ultrashort multimegagauss magnetic pulses in plasmas. Phys Rev Lett 2002; 89:225002. [PMID: 12485075 DOI: 10.1103/physrevlett.89.225002] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2002] [Indexed: 05/24/2023]
Abstract
We demonstrate ultrashort (6 ps), multimegagauss (27 MG) magnetic pulses generated upon interaction of an intense laser pulse (10(16) W cm(-2), 100 fs) with a solid target. The temporal evolution of these giant fields generated near the critical layer is obtained with the highest resolution reported thus far. Particle-in-cell simulations and phenomenological modeling is used to explain the results. The first direct observations of anomalously rapid damping of plasma shielding currents produced in response to the hot electron currents penetrating the bulk plasma are presented.
Collapse
Affiliation(s)
- A S Sandhu
- Tata Institute of Fundamental Research, 1 Homi Bhabha Road, Mumbai 400 005, India
| | | | | | | | | | | | | |
Collapse
|
24
|
Sandhu AS, Zelefsky MJ, Lee HJ, Lombardi D, Fuks Z, Leibel SA. Long-term urinary toxicity after 3-dimensional conformal radiotherapy for prostate cancer in patients with prior history of transurethral resection. Int J Radiat Oncol Biol Phys 2000; 48:643-7. [PMID: 11020559 DOI: 10.1016/s0360-3016(00)00714-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE To report on the long-term urinary morbidity among prostate cancer patients with a prior history of a transurethral resection of the prostate (TURP) treated with high-dose 3-dimensional conformal radiotherapy (3D-CRT). METHODS AND MATERIALS Between 1988 and 1997, 1100 patients with clinically localized prostate cancer were treated with 3D-CRT. Of these, 120 patients (8%) were identified as having had a prior TURP and are the subjects of this analysis. The median age was 71 years (range: 49-83 years). The clinical stages of the patients were T1c: 33 (28%); T2a: 38 (32%); T2b: 15 (13%); and T3: 34 (27%). Neoadjuvant androgen ablation therapy was given to 39 (33%). The median radiation dose prescribed to the planning target volume was 75.6 Gy (range: 64.8-81 Gy). The median elapsed time from TURP to initiation of 3D-CRT was 69 months (range: 4-360 months). The median follow-up time was 51 months (range: 18-109 months). RESULTS Five patients of the 120 with a prior history of TURP (4%) developed a urethral stricture after 3D-CRT which was corrected with dilatation. The 5-year actuarial likelihood of >/= Grade 2 late urinary toxicities was 9%. No Grade 4 urinary toxicities were observed in this group of patients. Among 110 patients who were completely continent of urine prior to 3D-CRT, 10 (9%) developed stress incontinence requiring 1 pad daily for protection or experienced occasional leakage (not requiring pad protection). The 5-year incidence of >/= Grade 1 stress incontinence was 18% in patients who developed acute >/= Grade 2 GU symptoms during the course of 3D-CRT compared to 7% for patients who experienced Grade 1 or no acute urinary symptoms (p = 0.05). The radiation dose (>/=75.6 Gy vs. <75.6 Gy), the number of prior TURP procedures, or the volume of resected tissue at the time of TURP had no significant impact on the long-term urinary morbidity outcome. A multivariate analysis demonstrated that the presence of Grade 2 acute urinary symptoms was the only predictor of >/= Grade 1 stress incontinence after 3D-CRT in this group of patients. CONCLUSIONS Despite prior TURP, the incidence of >/= Grade 3 urinary toxicities is low. Nevertheless, especially among patients with a prior history of TURP who experience Grade 2 acute urinary symptoms during radiation treatment, a higher risk of stress incontinence is observed.
Collapse
Affiliation(s)
- A S Sandhu
- Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY 10024, USA
| | | | | | | | | | | |
Collapse
|
25
|
Tobin CR, Sabatte E, Sandhu AS, Penafiel E. A neonatal care map based on gestational age. Neonatal Netw 1998; 17:41-51. [PMID: 9592499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Care maps have been used successfully in the adult population. To evaluate the use of these patient care models in the neonatal population, one Level III NICU compared data on 146 infants who ranged in gestational age from 24 to 33 weeks. Nine clinical benchmarks were identified as serving to define the infant's progress. These nine benchmarks were back to birth weight, extubation, discontinuation of hyperalimentation, discontinuation of NCPAP, feeding trial via orogastric tube, weaned to open crib, discontinuation of oxygen, full oral feedings, and discharge home. Gestational age was consistently observed to be the dominant determinant of the infant's readiness to achieve these physiologic tasks. The result of this project is a neonatal care map, based on gestational age. This care map outlines the expected treatment and response of the neonatal patient. It serves as a guide for both clinicians and families.
Collapse
Affiliation(s)
- C R Tobin
- Neonatal Intensive Care Unit, Alta Bates Medical Center in Berkeley, CA 94705, USA
| | | | | | | |
Collapse
|
26
|
Rao PR, Sandhu AS. EXTENSIVE ABDOMINAL HYDATID DISEASE. Med J Armed Forces India 1998; 54:65-66. [PMID: 28775421 DOI: 10.1016/s0377-1237(17)30418-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- P R Rao
- Senior Adviser (Surgery), 158 Base Hospital, C/o 99 APO (158 Base Hospital)
| | - A S Sandhu
- Graded Specialist (Surgery), 158 Base Hospital, C/o 99 APO (158 Base Hospital)
| |
Collapse
|
27
|
Abstract
No-scalpel vasectomy employs a refined method of dissection and delivery of the vas deferens. We compared no-scalpel vasectomy with standard incisional vasectomy in 176 patients over a 33 month period. The haemorrhage rate was 1.08 per cent for no-scalpel vasectomy compared with 11.9 per cent for standard vasectomy (p < 0.005). The infection rate was 3.26 per cent for no-scalpel vasectomy as against 14.28 per cent for standard vasectomy (p < 0.01). There was a 37.5 per cent reduction in operating time and a substantial reduction in pain during and after the procedure when no-scalpel vasectomy was performed and also there was no failure of vasectomy. No-scalpel vasectomy is a satisfactory alternative to standard vasectomy with fewer complications and increased patient acceptability.
Collapse
Affiliation(s)
- A S Sandhu
- Graded Specialist (Surgery), 158 Base Hospital, C/o 99 APO
| | - P R Kao
- Senior Adviser (Surgery), 158 Base Hospital, C/o 99 APO
| |
Collapse
|
28
|
Sandhu AS, Patel F, Singh DP, Sharma SC, Negi PS, Ayyagari S, Gupta BD. Results of treatment in endometrial carcinoma: ten years experience. Indian J Cancer 1997; 34:77-83. [PMID: 9491666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
From 1980 to 1989, 145 patients of histologically proven adenocarcinoma of the endometrium were seen and treated at the Department of Radiotherapy, Postgraduate Institute of Medical Education and Research, Chandigarh, Majority of the patients (84/145) presented with FIGO stage I disease. Relationship of myometrial invasion to grade was highly significant (p < 0.001). One hundred and seven patients were treated by surgery in combination with pre-operative or post-operative radiotherapy. The importance of various prognostic factors was assessed and grade of the tumour had statistically highly significant effect on survival (p < 0.005). Postoperative radiotherapy is recommended in patients with poor prognostic factors.
Collapse
Affiliation(s)
- A S Sandhu
- Department of Radiotherapy, Post-Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | | | | | | | | | | |
Collapse
|
29
|
Affiliation(s)
- P Rao
- Senior Adviser (Surgery), 158 Base Hospital, C/O 99 APO
| | - A S Sandhu
- Classified Specialist (Surgery), 158 Base Hospital, C/O 99 APO
| |
Collapse
|
30
|
|
31
|
Pandove SP, Singh K, Sandhu AS. Growth of term infants during neonatal period. Indian Pediatr 1994; 31:675-8. [PMID: 7896392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
One hundred and seventy two healthy term (T) appropriate-for-dates (AFD) singleton neonates were prospectively studied from birth until 28 days of age for changes in weight, occipitofrontal circumference (OFC), chest circumference (CC), midarm circumference (MAC), thigh circumference (TC) and crownheel length (CHL). Male babies had statistically significant (p < 0.05) higher values than females for weight, OFC, CC and CHL at birth and for all the six parameters at 28 days. The mean loss of weight during the first 72 hours was 120 g and 140 g and the mean gain in weight at 28 days was 640 g and 520 g for males and females, respectively. After an initial decrease, OFC, CC and TC showed a mean growth of 1.9 cm and 1.9 cm, 1.4 cm and 1.1 cm and 0.9 cm and 0.7 cm in males and females, respectively by 28 days. By that age CHL showed a mean growth of 3.2 cm in males and 3.0 cm in females. Although both groups after an initial decrease in MAC, had started showing growth by 2nd week, female babies fell short by 0.1 cm of mean birth values by 28 days while males had a mean growth of 0.1 cm.
Collapse
Affiliation(s)
- S P Pandove
- Department of Pediatrics, Rajindra Hospital/Government Medical College, Patiala
| | | | | |
Collapse
|
32
|
Azimi PH, Levernier K, Lefrak LM, Petru AM, Barrett T, Schenck H, Sandhu AS, Duritz G, Valesco M. Malassezia furfur: a cause of occlusion of percutaneous central venous catheters in infants in the intensive care nursery. Pediatr Infect Dis J 1988; 7:100-3. [PMID: 3125516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Growth of Malassezia furfur in the intravascular catheter used for administration of lipid emulsion resulted in occlusion of deep intravascular Silastic catheters in 12 infants in 2 intensive care nurseries. At the time of occlusion visible growth was noted in the clear catheter which was connected to the Silastic intravascular line. Five infants showed clinical signs suggestive of sepsis. The yield of M. furfur from blood cultures and catheter tips was low even when oil enrichment was used. The highest yield of M. furfur was found in the connecting catheter (11 of 11). The source from and the route by which M. furfur entered the catheter remain unclear. The potential portals of entry include the proximal and distal ends of the connecting catheter as well as the colonized skin of the infants and caretakers.
Collapse
Affiliation(s)
- P H Azimi
- Division of Infectious Diseases, Children's Hospital, Oakland, CA 94609
| | | | | | | | | | | | | | | | | |
Collapse
|
33
|
|