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Arora VK, Chopra KK. Pathways to end TB- challenges. Indian J Tuberc 2024; 71:1-2. [PMID: 38296381 DOI: 10.1016/j.ijtb.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 02/08/2024]
Affiliation(s)
- V K Arora
- TB Association of India, 3 Red Cross Rd, Gokul Nagar, Sansad Marg Area, New Delhi, Delhi 110001, India.
| | - Kamal Kishore Chopra
- New Delhi Tuberculosis Centre, Jawaharlal Nehru Marg, Delhi Gate, New Delhi 110002, India.
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Arora VK, Kishore Chopra K. Pediatric tuberculosis - A diagnostic Dilemma. Indian J Tuberc 2023; 70 Suppl 1:S6-S7. [PMID: 38110262 DOI: 10.1016/j.ijtb.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 11/09/2023] [Indexed: 12/20/2023]
Affiliation(s)
- V K Arora
- TB Association of India, 3, Red Cross Rd, Gokul Nagar, Sansad Marg Area, New Delhi, Delhi, 110001, India.
| | - Kamal Kishore Chopra
- New Delhi Tuberculosis Centre, Jawaharlal Nehru Marg, Delhi Gate, New Delhi, 110002, India.
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Arora VK, Jindal SK, Katiyar SK, Behra D, Talwar D, Sarin R, Dhar R, Mehta P, Bhargava S, Singhal P, Joshi S, Tiwaskar M, Nikam C, Chatterjee A, Vora A. Genomic revolution: Transforming tuberculosis diagnosis and treatment with the use of Whole Genome Sequencing - A consensus statement. Indian J Tuberc 2023; 70:383-389. [PMID: 37968042 DOI: 10.1016/j.ijtb.2023.10.002] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 11/17/2023]
Abstract
Tuberculosis (TB) is a preventable, treatable, and curable disease. However, in 2020, 9∙9 million people were estimated to have developed tuberculosis, and 1.5 million people were estimated to have died from it. Whereas in India, 2.6 million were diagnosed with TB and 436,000 succumbed to TB in 2019. India (26%) is the major contributor to the global drop in TB cases. The COVID-19 pandemic has substantially reduced access to services for the diagnosis and treatment of TB, resulting in an increase in deaths and a reversal in global progress. [1] Presently, TB incidence is falling at a rate of 2% per year, obstructed mainly by the rearing pandemic of drug-resistant tuberculosis (DRTB). Particularly concerning is multi-drug resistant TB (MDRTB), defined as resistance towards isoniazid (INH) and rifampicin (RIF). [2] The World Health Organization (WHO) targeted to reduce worldwide TB incidence by 90% until 2035. (1) Early initiation of effective treatment based on susceptibility patterns of the Mycobacterium tuberculosis complex (MTBC) is considered key to successful TB control in countries with high DRTB incidence. Worldwide MDRTB treatment outcomes are poor, with cure rates less than 60% (2) due to the lack of comprehensive Drug Susceptibility Testing (DST) in most high MDRTB burden countries. This is leading to the inadequate anti-TB activity of the provided regimens (3-5), unlike regimens advised for DST assure optimal results. (6) In addition to resistances to the established regimens, the resistance to the newer DRTB drugs is increasing. On World TB Day 2022, Academy of Advanced Medical Education, Thyrocare Technologies Limited and HyastackAnalytics - IITB along with expert pulmonologist and renowned physicians from India convened for an advisory board meeting in Delhi on 20th March 2022 to discuss the role of Whole Genome Sequencing (WGS) in the diagnosis and management of TB. Objectives and specific topics relating to WGS in MDRTB were discussed, each expert shared their views, which led to a group discussion with a commitment to putting the patient first, and increasing their collective efforts, the organizations recognized that it is possible to make this goal a reality. The organizations involved in the discussion have declared their commitment to engaging in collaborative efforts to tackle DRTB detection efficiently. They advocate for strengthening access to WGS TB services, controlling and preventing TB, improving surveillance and drug resistance management, and investing in research and development. This Round Table serves as a framework to build on and ensure that the goal of ending TB is achievable with WGS services wherever needed. Post discussion, a uniform consensus was said to be arrived if more than 80% board members agreed to the statement. The present paper is the outcome of aspects presented and discussed in the advisory board meeting.
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Affiliation(s)
- V K Arora
- Pulmonologist and Tuberculous and Chest Diseases Specialist, Delhi, India
| | - S K Jindal
- Director, Jindal Clinics, Chandigarh, India
| | - S K Katiyar
- Pulmonologist, TB & Chest Diseases Specialist, Kanpur, India
| | - Digambar Behra
- Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepak Talwar
- Senior Consultant & Chairman - Metro Respiratory Center Pulmonology & Sleep Medicine, Noida, India
| | - Rohit Sarin
- Principal Consultant and Former Director, National Institute of Tuberculosis and Respiratory Diseases, Delhi, India
| | - Raja Dhar
- Department of Pulmonology C K Birla Group of Hospitals Kolkata, India
| | | | - Salil Bhargava
- Professor of Chest and TB at M G M Medical College, Indore, India
| | | | | | | | - Chaitali Nikam
- HaystackAnalytics, IITB, Mumbai, India; Thyrocare Technologies Limited, Mumbai, India
| | | | - Agam Vora
- Brahma Kumari's Global Hospital & Research Centre, Mumbai, India.
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Vora A, Mehta P, Arora VK, Behera D, Kar A, Katiyar SK, Samaria JK, Koul P, Jaychandra A, Singh BP, Kandi S, Nazir Shah N, Jain NK, Najeeb R, Ahmad S, Najib R, Faisal M, Dewan B. Aviptadil: A promising treatment option for acute respiratory distress syndrome. Indian J Tuberc 2023; 70:510-511. [PMID: 37968060 DOI: 10.1016/j.ijtb.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/28/2023] [Indexed: 11/17/2023]
Affiliation(s)
- Agam Vora
- Vora Clinic, Borivali West, Mumbai, Maharashtra, India
| | - Parthiv Mehta
- Mehta Hospital, Drive-in Road, Thaltej, Ahmedabad, Gujarat, India
| | - V K Arora
- Arora Clinic, C151, Sector 51, Kendriya Vihar, Noida, Uttar Pradesh, India
| | - D Behera
- Department of Pulmonology, Fortis Hospital, Mohali, Punjab, India
| | - Arindam Kar
- Department of Critical Care Medicine, HN Reliance Foundation Hospital and Research Centre, Girgaon, Mumbai, Maharashtra, India
| | - S K Katiyar
- Chest Care Centre, Swaroop Nagar, Kanpur, Uttar Pradesh, India
| | - J K Samaria
- Samaria Multi-Speciality & Chest Centre, Kabir Nagar Colony, Varanasi, Uttar Pradesh, India
| | - Parvaiz Koul
- Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu & Kashmir, India
| | - A Jaychandra
- Department of Pulmonology, Care Hospitals, Banjara Hills, Hyderabad, Telangana, India
| | - B P Singh
- Department of Respiratory & Critical Care, Midland Healthcare & Research Center, Lucknow, Uttar Pradesh, India
| | | | - Naveed Nazir Shah
- Chest Disease Hospital, Buchwara, Srinagar, Jammu and Kashmir, India
| | - N K Jain
- 57/58, Shastri Nagar, Jaipur, Rajasthan, India
| | - Rukhsana Najeeb
- SMHS Hospital, Karan Nagar, Srinagar, Jammu and Kashmir, India
| | - Sadiq Ahmad
- SMHS Hospital, Karan Nagar, Srinagar, Jammu and Kashmir, India
| | - Rayees Najib
- SMHS Hospital, Karan Nagar, Srinagar, Jammu and Kashmir, India
| | - Mir Faisal
- Magarmal Bagh, Near Shifa Hospital, Srinagar, Jammu and Kashmir, India
| | - Bhupesh Dewan
- Department of Medical Services, Zuventus Healthcare Limited, Zuventus House, Plot Y2, CTS No.: 358/A2, Near Nahur Railway Station, Nahur West, Mumbai 400078, Maharashtra, India.
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Ahmad P, Arora VK. Prevalance of tuberculosis amongst healthcare workers, working in DOTS/sputum microscopy centre in two different districts of state of Uttarakhand & Uttar Pradesh of India. Indian J Tuberc 2023; 70:405-408. [PMID: 37968045 DOI: 10.1016/j.ijtb.2023.03.011] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/04/2023] [Accepted: 03/22/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND & OBJECTIVE The Healthcare workers (HCWs) who work in DOTS/Sputum microscopy centre are exposed to higher risk of contacting tuberculosis (TB) comparatively to other health workers who are serving the other health sectors. The HCWs in DOTS are more exposed due to direct contact with patients suffering from TB or through sharing the infected air space with the infectious patients. The aim of the study is to know the prevalance of TB disease amongst the HCWs who are working in DOTS cum Sputum Microscopy Centre's under RNTCP in two different districts of state of Uttar Pradesh (UP) and Uttarakhand (UK) of india. METHODS The prospective cross-sectional study is conducted in two districts of different states having high burden of TB disease in UP and low burden of TB disease in UK state. All 100% (130) staff i.e. Medical officers, Sputum microscopy technicians, DOTS providers of DOTS cum Sputum Microscopy centre's of both selected Ghaziabad (UP) and Dehradun (UK) districts are covered in the study. RESULTS The 4.6% (6) healthcare workers of both the districts were taking ATT at the time of interview and 13.8% (18) HCWs had taken the ATT in past. The 62.5% (15) HCWs i.e 55.5% (5) from Dehradun district and 66.6% (10) from Ghaziabad district preferred to have a ATT from the private medical store inspite of taking DOTS with assumption of low efficacy of drugs and high toxicity. The 58.33% (14) HCWs ie 55.5% (5) staff members of DOTS/sputum microscopy centre in Dehradun & 60.0% (9) staff members of DOTS/sputum microscopy centre in Ghaziabad district had not notified about the status of their disease to the health care authority due the assumption that they may be asked to leave the job or to go on a long unpaid leave. CONCLUSION The 18.4% (24) HCWs of both the district got TB disease during their working in DOTS/Sputum microscopy centre and 4.6% (6) HCWs of both the districts were taking the ATT at the time of interview.
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Affiliation(s)
- Parvez Ahmad
- Department of Chest & TB, Santosh Medical College & University, Ghaziabad, UP, India.
| | - V K Arora
- Santosh University, Ghaziabad, UP, India
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Agrawal S, Singal A, Grover C, Das S, Arora VK, Madhu SV. Prevalence of onychomycosis in patients with diabetes mellitus: A cross-sectional study from a tertiary care hospital in North India. Indian J Dermatol Venereol Leprol 2023; 89:710-717. [PMID: 37067104 DOI: 10.25259/ijdvl_360_2022] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 12/11/2022] [Indexed: 04/05/2023]
Abstract
Background Though diabetes mellitus (DM) is a well-recognised risk factor for onychomycosis (OM), the epidemiology of OM in diabetic patients remains largely unexplored, especially from the Indian subcontinent. Aims and objectives To estimate the prevalence of OM in diabetic patients, to identify and analyse risk factors, and correlate the severity of nail changes with glycemic control (HBA1c). Methods This cross-sectional, analytical study involved 300 diabetic patients. Patients with the clinical diagnosis of OM, supplanted by at least two of the four tests (KOH, culture, onychoscopy and nail histopathology) were considered cases of OM. Demographic and haematological profile was analysed using chi-square test/ Fischer's exact test. Logistic regression was applied to assess the independent risk factors. Results The prevalence of OM in DM patients was 34% (102/300) and significant risk factors included; age >60 years, male gender, closed shoes, disease duration >5 years, high BMI (>25) and lack of awareness about nail changes. Distal and lateral subungual OM (78%) was the commonest presentation followed by proximal subungual OM, superficial OM and total dystrophic OM. Correlation between HbA1c and the number of nails involved was found to be significant. Limitation As cases were recruited from a hospital setting, there could be chances of Berksonian bias. Conclusion The prevalence of OM in diabetic patients is high and the severity of nail changes correlates with HbA1C levels. It is important to diagnose OM early in order to treat and prevent complications.
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Affiliation(s)
- Sonia Agrawal
- Department of Dermatology & STD, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Archana Singal
- Department of Dermatology & STD, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Chander Grover
- Department of Dermatology & STD, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Shukla Das
- Department of Microbiology, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - V K Arora
- Department of Pathology, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - S V Madhu
- Department of Endocrinology, University College of Medical Sciences and GTB Hospital, Delhi, India
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Chopra KK, Matta S, Arora VK. Drug resistant tuberculosis among elderly: Challenges. Indian J Tuberc 2022; 69 Suppl 2:S202-S204. [PMID: 36400509 DOI: 10.1016/j.ijtb.2022.10.022] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
The article deals with challenges faced by the geriatric populations while on MDR treatment. Risk factors like tobacco use, low socio-economic status, previous disease, longer delays in seeking treatment and reduced mobility are some of the challenges while initiating MDR treatment. Other issues like drug-related adverse events and increased co-morbidity pose a major challenge while treating patients. Susceptibility among the geriatric age group includes various anatomical and physiological changes including nutritional deficiencies and co morbidities.
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Affiliation(s)
- K K Chopra
- Director New Delhi Tuberculosis Centre, India
| | - S Matta
- Epidemiologist New Delhi Tuberculosis centre, India.
| | - V K Arora
- Vice Chairman (P & R) and Hony, Technical advisor, Tuberculosis Association of India, India
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Katiyar SK, Gaur SN, Solanki RN, Sarangdhar N, Suri JC, Kumar R, Khilnani GC, Chaudhary D, Singla R, Koul PA, Mahashur AA, Ghoshal AG, Behera D, Christopher DJ, Talwar D, Ganguly D, Paramesh H, Gupta KB, Kumar T M, Motiani PD, Shankar PS, Chawla R, Guleria R, Jindal SK, Luhadia SK, Arora VK, Vijayan VK, Faye A, Jindal A, Murar AK, Jaiswal A, M A, Janmeja AK, Prajapat B, Ravindran C, Bhattacharyya D, D'Souza G, Sehgal IS, Samaria JK, Sarma J, Singh L, Sen MK, Bainara MK, Gupta M, Awad NT, Mishra N, Shah NN, Jain N, Mohapatra PR, Mrigpuri P, Tiwari P, Narasimhan R, Kumar RV, Prasad R, Swarnakar R, Chawla RK, Kumar R, Chakrabarti S, Katiyar S, Mittal S, Spalgais S, Saha S, Kant S, Singh VK, Hadda V, Kumar V, Singh V, Chopra V, B V. Indian Guidelines on Nebulization Therapy. Indian J Tuberc 2022; 69 Suppl 1:S1-S191. [PMID: 36372542 DOI: 10.1016/j.ijtb.2022.06.004] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 06/16/2023]
Abstract
Inhalational therapy, today, happens to be the mainstay of treatment in obstructive airway diseases (OADs), such as asthma, chronic obstructive pulmonary disease (COPD), and is also in the present, used in a variety of other pulmonary and even non-pulmonary disorders. Hand-held inhalation devices may often be difficult to use, particularly for children, elderly, debilitated or distressed patients. Nebulization therapy emerges as a good option in these cases besides being useful in the home care, emergency room and critical care settings. With so many advancements taking place in nebulizer technology; availability of a plethora of drug formulations for its use, and the widening scope of this therapy; medical practitioners, respiratory therapists, and other health care personnel face the challenge of choosing appropriate inhalation devices and drug formulations, besides their rational application and use in different clinical situations. Adequate maintenance of nebulizer equipment including their disinfection and storage are the other relevant issues requiring guidance. Injudicious and improper use of nebulizers and their poor maintenance can sometimes lead to serious health hazards, nosocomial infections, transmission of infection, and other adverse outcomes. Thus, it is imperative to have a proper national guideline on nebulization practices to bridge the knowledge gaps amongst various health care personnel involved in this practice. It will also serve as an educational and scientific resource for healthcare professionals, as well as promote future research by identifying neglected and ignored areas in this field. Such comprehensive guidelines on this subject have not been available in the country and the only available proper international guidelines were released in 1997 which have not been updated for a noticeably long period of over two decades, though many changes and advancements have taken place in this technology in the recent past. Much of nebulization practices in the present may not be evidence-based and even some of these, the way they are currently used, may be ineffective or even harmful. Recognizing the knowledge deficit and paucity of guidelines on the usage of nebulizers in various settings such as inpatient, out-patient, emergency room, critical care, and domiciliary use in India in a wide variety of indications to standardize nebulization practices and to address many other related issues; National College of Chest Physicians (India), commissioned a National task force consisting of eminent experts in the field of Pulmonary Medicine from different backgrounds and different parts of the country to review the available evidence from the medical literature on the scientific principles and clinical practices of nebulization therapy and to formulate evidence-based guidelines on it. The guideline is based on all possible literature that could be explored with the best available evidence and incorporating expert opinions. To support the guideline with high-quality evidence, a systematic search of the electronic databases was performed to identify the relevant studies, position papers, consensus reports, and recommendations published. Rating of the level of the quality of evidence and the strength of recommendation was done using the GRADE system. Six topics were identified, each given to one group of experts comprising of advisors, chairpersons, convenor and members, and such six groups (A-F) were formed and the consensus recommendations of each group was included as a section in the guidelines (Sections I to VI). The topics included were: A. Introduction, basic principles and technical aspects of nebulization, types of equipment, their choice, use, and maintenance B. Nebulization therapy in obstructive airway diseases C. Nebulization therapy in the intensive care unit D. Use of various drugs (other than bronchodilators and inhaled corticosteroids) by nebulized route and miscellaneous uses of nebulization therapy E. Domiciliary/Home/Maintenance nebulization therapy; public & health care workers education, and F. Nebulization therapy in COVID-19 pandemic and in patients of other contagious viral respiratory infections (included later considering the crisis created due to COVID-19 pandemic). Various issues in different sections have been discussed in the form of questions, followed by point-wise evidence statements based on the existing knowledge, and recommendations have been formulated.
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Affiliation(s)
- S K Katiyar
- Department of Tuberculosis & Respiratory Diseases, G.S.V.M. Medical College & C.S.J.M. University, Kanpur, Uttar Pradesh, India.
| | - S N Gaur
- Vallabhbhai Patel Chest Institute, University of Delhi, Respiratory Medicine, School of Medical Sciences and Research, Sharda University, Greater NOIDA, Uttar Pradesh, India
| | - R N Solanki
- Department of Tuberculosis & Chest Diseases, B. J. Medical College, Ahmedabad, Gujarat, India
| | - Nikhil Sarangdhar
- Department of Pulmonary Medicine, D. Y. Patil School of Medicine, Navi Mumbai, Maharashtra, India
| | - J C Suri
- Department of Pulmonary, Critical Care & Sleep Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Raj Kumar
- Vallabhbhai Patel Chest Institute, Department of Pulmonary Medicine, National Centre of Allergy, Asthma & Immunology; University of Delhi, Delhi, India
| | - G C Khilnani
- PSRI Institute of Pulmonary, Critical Care, & Sleep Medicine, PSRI Hospital, Department of Pulmonary Medicine & Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Dhruva Chaudhary
- Department of Pulmonary & Critical Care Medicine, Pt. Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Rupak Singla
- Department of Tuberculosis & Respiratory Diseases, National Institute of Tuberculosis & Respiratory Diseases (formerly L.R.S. Institute), Delhi, India
| | - Parvaiz A Koul
- Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Ashok A Mahashur
- Department of Respiratory Medicine, P. D. Hinduja Hospital, Mumbai, Maharashtra, India
| | - A G Ghoshal
- National Allergy Asthma Bronchitis Institute, Kolkata, West Bengal, India
| | - D Behera
- Department of Pulmonary Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - D J Christopher
- Department of Pulmonary Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Deepak Talwar
- Metro Centre for Respiratory Diseases, Noida, Uttar Pradesh, India
| | | | - H Paramesh
- Paediatric Pulmonologist & Environmentalist, Lakeside Hospital & Education Trust, Bengaluru, Karnataka, India
| | - K B Gupta
- Department of Tuberculosis & Respiratory Medicine, Pt. Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences Rohtak, Haryana, India
| | - Mohan Kumar T
- Department of Pulmonary, Critical Care & Sleep Medicine, One Care Medical Centre, Coimbatore, Tamil Nadu, India
| | - P D Motiani
- Department of Pulmonary Diseases, Dr. S. N. Medical College, Jodhpur, Rajasthan, India
| | - P S Shankar
- SCEO, KBN Hospital, Kalaburagi, Karnataka, India
| | - Rajesh Chawla
- Respiratory and Critical Care Medicine, Indraprastha Apollo Hospitals, New Delhi, India
| | - Randeep Guleria
- All India Institute of Medical Sciences, Department of Pulmonary Medicine & Sleep Disorders, AIIMS, New Delhi, India
| | - S K Jindal
- Department of Pulmonary Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - S K Luhadia
- Department of Tuberculosis and Respiratory Medicine, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India
| | - V K Arora
- Indian Journal of Tuberculosis, Santosh University, NCR Delhi, National Institute of TB & Respiratory Diseases Delhi, India; JIPMER, Puducherry, India
| | - V K Vijayan
- Vallabhbhai Patel Chest Institute, Department of Pulmonary Medicine, University of Delhi, Delhi, India
| | - Abhishek Faye
- Centre for Lung and Sleep Disorders, Nagpur, Maharashtra, India
| | | | - Amit K Murar
- Respiratory Medicine, Cronus Multi-Specialty Hospital, New Delhi, India
| | - Anand Jaiswal
- Respiratory & Sleep Medicine, Medanta Medicity, Gurugram, Haryana, India
| | - Arunachalam M
- All India Institute of Medical Sciences, New Delhi, India
| | - A K Janmeja
- Department of Respiratory Medicine, Government Medical College, Chandigarh, India
| | - Brijesh Prajapat
- Pulmonary and Critical Care Medicine, Yashoda Hospital and Research Centre, Ghaziabad, Uttar Pradesh, India
| | - C Ravindran
- Department of TB & Chest, Government Medical College, Kozhikode, Kerala, India
| | - Debajyoti Bhattacharyya
- Department of Pulmonary Medicine, Institute of Liver and Biliary Sciences, Army Hospital (Research & Referral), New Delhi, India
| | | | - Inderpaul Singh Sehgal
- Department of Pulmonary Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - J K Samaria
- Centre for Research and Treatment of Allergy, Asthma & Bronchitis, Department of Chest Diseases, IMS, BHU, Varanasi, Uttar Pradesh, India
| | - Jogesh Sarma
- Department of Pulmonary Medicine, Gauhati Medical College and Hospital, Guwahati, Assam, India
| | - Lalit Singh
- Department of Respiratory Medicine, SRMS Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
| | - M K Sen
- Department of Respiratory Medicine, ESIC Medical College, NIT Faridabad, Haryana, India; Department of Pulmonary, Critical Care & Sleep Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - Mahendra K Bainara
- Department of Pulmonary Medicine, R.N.T. Medical College, Udaipur, Rajasthan, India
| | - Mansi Gupta
- Department of Pulmonary Medicine, Sanjay Gandhi PostGraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Nilkanth T Awad
- Department of Pulmonary Medicine, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Narayan Mishra
- Department of Pulmonary Medicine, M.K.C.G. Medical College, Berhampur, Orissa, India
| | - Naveed N Shah
- Department of Pulmonary Medicine, Chest Diseases Hospital, Government Medical College, Srinagar, Jammu & Kashmir, India
| | - Neetu Jain
- Department of Pulmonary, Critical Care & Sleep Medicine, PSRI, New Delhi, India
| | - Prasanta R Mohapatra
- Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Orissa, India
| | - Parul Mrigpuri
- Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - Pawan Tiwari
- School of Excellence in Pulmonary Medicine, NSCB Medical College, Jabalpur, Madhya Pradesh, India
| | - R Narasimhan
- Department of EBUS and Bronchial Thermoplasty Services at Apollo Hospitals, Chennai, Tamil Nadu, India
| | - R Vijai Kumar
- Department of Pulmonary Medicine, MediCiti Medical College, Hyderabad, Telangana, India
| | - Rajendra Prasad
- Vallabhbhai Patel Chest Institute, University of Delhi and U.P. Rural Institute of Medical Sciences & Research, Safai, Uttar Pradesh, India
| | - Rajesh Swarnakar
- Department of Respiratory, Critical Care, Sleep Medicine and Interventional Pulmonology, Getwell Hospital & Research Institute, Nagpur, Maharashtra, India
| | - Rakesh K Chawla
- Department of, Respiratory Medicine, Critical Care, Sleep & Interventional Pulmonology, Saroj Super Speciality Hospital, Jaipur Golden Hospital, Rajiv Gandhi Cancer Hospital, Delhi, India
| | - Rohit Kumar
- Department of Pulmonary, Critical Care & Sleep Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | - S Chakrabarti
- Department of Pulmonary, Critical Care & Sleep Medicine, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India
| | | | - Saurabh Mittal
- Department of Pulmonary, Critical Care & Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sonam Spalgais
- Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | | | - Surya Kant
- Department of Respiratory (Pulmonary) Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - V K Singh
- Centre for Visceral Mechanisms, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - Vijay Hadda
- Department of Pulmonary Medicine & Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - Vikas Kumar
- All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Virendra Singh
- Mahavir Jaipuria Rajasthan Hospital, Jaipur, Rajasthan, India
| | - Vishal Chopra
- Department of Chest & Tuberculosis, Government Medical College, Patiala, Punjab, India
| | - Visweswaran B
- Interventional Pulmonology, Yashoda Hospitals, Hyderabad, Telangana, India
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Gupta S, Arora VK, Gupta AK, Bandhu Gupta M. Utilization of health care services by elderly for respiratory diseases including TB - Challenges. Indian J Tuberc 2022; 69 Suppl 2:S246-S252. [PMID: 36400518 DOI: 10.1016/j.ijtb.2022.10.013] [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] [Received: 08/22/2022] [Revised: 08/27/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022]
Abstract
Progressive functional decline of all body organ systems in association with decreased immunity makes elderly vulnerable to all types of diseases including respiratory diseases. Advances in medical fields have resulted in increasing proportion of elderly globally. Healthcare demands of elderly population are complex. Provision of healthcare services for this continuously increasing population subgroup & ensuring their adequate utilization is full of challenges. These are demographic, socioeconomic, financial, physical accessibility, quality of healthcare services, attitudinal & transportation related. Large size of this subgroup with special healthcare needs in context of limited available resources of middle income country like India is the biggest challenge. Poor educational status & socioeconomic condition of Indian elderly, dependence on family, absence of formal social security & healthcare security complicates situation further. Condition of elderly females is particularly worse. In view of poor physical ability with often associated physical disability makes accessibility of healthcare services also significant factor. Overcoming negative attitudinal factors prevalent in Indian elderly & make them utilize available healthcare services is another huge challenge. Quality of healthcare services in form of availability of required expertise & equipments, attitude of healthcare providers towards elderly patients & convenience in utilization of these services also play an important role. Special provisions in TB control program for elderly in view of their complex needs, high prevalence, morbidity & mortality are also required.
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Affiliation(s)
- Sonisha Gupta
- Department of Respiratory Medicine, SMSR, Sharda University, Greater Noida, India.
| | - V K Arora
- Respiratory Diseases, Senior Consultant, Ex-Vice Chancellor, Santosh University, NCR, Delhi
| | | | - Mohan Bandhu Gupta
- Department of Respiratory Medicine, SMSR, Sharda University, Greater Noida, India
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Padmapriyadarsini C, Banurekha V, Arora VK. Challenges in TB control and the anticipated COVID-19 third wave: Way forward. Indian J Tuberc 2021; 68:425-427. [PMID: 34752307 PMCID: PMC8316627 DOI: 10.1016/j.ijtb.2021.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 11/25/2022]
Affiliation(s)
- C Padmapriyadarsini
- ICMR-National Institute for Research in Tuberculosis, Chetput, Chennai, India.
| | - V Banurekha
- ICMR-National Institute for Research in Tuberculosis, Chetput, Chennai, India
| | - V K Arora
- Tuberculosis Association of India, India
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Chopra KK, Matta S, Arora VK. Impact of COVID-19 and tobacco on TB control. Indian J Tuberc 2021; 68S:S4-S6. [PMID: 34538390 PMCID: PMC8384480 DOI: 10.1016/j.ijtb.2021.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 08/10/2021] [Indexed: 06/13/2023]
Affiliation(s)
- K K Chopra
- New Delhi Tuberculosis Centre, New Delhi, India; Indian Journal of Tuberculosis, India.
| | - S Matta
- New Delhi Tuberculosis Centre, New Delhi, India
| | - V K Arora
- TB Association of India, India; Indian Journal of Tuberculosis, India
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Affiliation(s)
- K K Chopra
- New Delhi Tuberculosis Centre, New Delhi, India; Indian Journal of Tuberculosis, India.
| | - S Matta
- New Delhi Tuberculosis Centre, New Delhi, India
| | - V K Arora
- TB Association of India, India; Indian Journal of Tuberculosis, India
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13
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Bhargava S, Chopra KK, Arora VK. NATCON virtual 2020 - Challenges and way ahead. Indian J Tuberc 2021; 68:1-2. [PMID: 33641828 DOI: 10.1016/j.ijtb.2021.02.002] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Salil Bhargava
- Pulmonary Medicine, M G M Medical College, Indore, India
| | - K K Chopra
- New Delhi Tuberculosis Centre, New Delhi, India; Indian Journal of Tuberculosis, India.
| | - V K Arora
- TB Association of India, India; Indian Journal of Tuberculosis, India
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Matta S, Arora VK, Chopra KK. Lessons to be learnt from 100 year old 1918 influenza pandemic viz a viz 2019 corona pandemic with an eye on NTEP. Indian J Tuberc 2020; 67:S132-S138. [PMID: 33308659 PMCID: PMC7543972 DOI: 10.1016/j.ijtb.2020.09.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Received: 09/22/2020] [Accepted: 09/28/2020] [Indexed: 12/28/2022]
Abstract
The article is about the 1918 H1N1 flu pandemic also called the “Spanish flu“ which killed 50 million plus people worldwide, and the coronavirus pandemic (Covid-19) which has spread in the world at an alarming pace. As of now there are 11,327,790 cases and 532,340 deaths globally. Aim of this article is to draw conclusions and share knowledge from both the pandemics and apply these lessons in other health programmes.
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Affiliation(s)
| | - V K Arora
- Honorary Treasurer & Trustee TAI, TB Association of India
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Abstract
The present article highlights morbidity and mortality trends of Covid 19 in the last 3 months in top 10 countries of the world. In spite of efforts being undertaken, all countries are showing an increasing trend in terms of morbidity and mortality. The order of countries in terms of mortality and morbidity has changed in the last 3 months. Various efforts are being undertaken by WHO and other agencies world over including the vaccine development initiative.
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Affiliation(s)
| | - K K Chopra
- STDC, Delhi New Delhi TB Centre, New Delhi, India
| | - V K Arora
- Honorary Treasurer & Trustee TAI TB Association of India, India
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Rajpal S, Arora VK. Latent TB (LTBI) treatment: Challenges in India with an eye on 2025: "To Treat LTBI or not to treat, that is the question". Indian J Tuberc 2020; 67:S43-S47. [PMID: 33308671 DOI: 10.1016/j.ijtb.2020.09.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 10/23/2022]
Abstract
Latent tuberculosis infection (LTBI) is defined as a consistent immune response to Mycobacterium tuberculosis antigens without evidence of clinically evident active tuberculosis (TB). Diagnosis and treatment for LTBI are important for TB, especially in high-risk populations especially in high prevalent country like India. Tuberculin skin test (TST) and interferon-gamma release assays (IGRAs) are used to diagnose LTBI. Therefore an unequivocal policy /of diagnosis and treatment of LTBI will serve to ameliorate the standards of the Indian health scenario and bring the TB infection to the propinquity of its ultimate elimination.
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Affiliation(s)
| | - V K Arora
- Vice Chairman Publication & Research, Honorary Treasurer, Honorary Technical Advisor, TB Association of India, India
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Abstract
A group of senior doctors with vast clinical experience met on 19th July'20 under the aegis of Academy of Advanced Medical Education. The panel looked at Ivermectin, one of the old molecule and evaluated it's use in COVID 19 (Novel Coronavirus Disease 2019) management. After critical panel discussion, all the attending doctors came to a conclusion that Ivermectin can be a potential molecule for prophylaxis and treatment of people infected with Coronavirus, owing to its anti-viral properties coupled with effective cost, availability and good tolerability and safety.
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Affiliation(s)
- Agam Vora
- Academy of Advanced Medical Education, Vora Clinic, 302, Soni Shopping Center, L T Road, Borivali West, Mumbai, 400092, Maharashtra, India.
| | - V K Arora
- Academy of Advanced Medical Education, Vora Clinic, 302, Soni Shopping Center, L T Road, Borivali West, Mumbai, 400092, Maharashtra, India
| | - D Behera
- Academy of Advanced Medical Education, Vora Clinic, 302, Soni Shopping Center, L T Road, Borivali West, Mumbai, 400092, Maharashtra, India
| | - Surya Kant Tripathy
- Department of Respiratory Medicine, King George's Medical University, Lucknow, U.P, India
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Sharma A, Bisht D, Das S, Rai G, Dutt S, Arora VK. Molecular Detection of Aspergillus in Sputum of Patients with Lower Respiratory Tract Infections. Int J Appl Basic Med Res 2020; 10:86-90. [PMID: 32566523 PMCID: PMC7289198 DOI: 10.4103/ijabmr.ijabmr_364_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 03/30/2019] [Accepted: 02/13/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Raised incidences of respiratory tract infections due to fungal agents in immunocompetent individuals are a cause of concern due to the unavailability of rapid diagnostic methods. MATERIALS AND METHODS Sputum and serum samples were collected from patients having lower respiratory tract infections (LRTIs), serum samples were screened for the presence of anti Aspergillus antibodies and sputum samples were homogenized and processed for identification of Aspergillus by conventional methods and further subjected to polymerase chain reaction (PCR) using genus-specific ITS 4-5 primers. RESULTS PCR identified Aspergillus in 28% sputum samples, which was high as compared to conventional methods. CONCLUSION Simple conventional PCR technique proves to be useful screening in for early identification of Aspergillus colonization in patients with LRTI, which can prevent irreversible damage in their lungs by fungal invasion.
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Affiliation(s)
- Alosha Sharma
- Department of Microbiology, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
| | - Dakshina Bisht
- Department of Microbiology, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
| | - Shukla Das
- Department of Microbiology, UCMS, GTBH, New Delhi, India
| | - Gargi Rai
- Department of Microbiology, UCMS, GTBH, New Delhi, India
| | - Shyama Dutt
- Department of Microbiology, UCMS, GTBH, New Delhi, India
| | - V K Arora
- Department of TB and Chest, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
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Affiliation(s)
- K K Chopra
- Director, New Delhi Tuberculosis Centre, New Delhi, India; Associate Executive Editor, Indian Journal of Tuberculosis, India
| | - V K Arora
- Vice Chairman (P&R), TB Association of India, India; Executive Editor, Indian Journal of Tuberculosis, India.
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Affiliation(s)
- V K Arora
- TB Association of India, Indian Journal of Tuberculosis, NITRD, Delhi, India.
| | - K K Chopra
- New Delhi Tuberculosis Centre, Indian Journal of Tuberculosis, New Delhi, India
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Chopra KK, Arora VK. Changing climate and respiratory diseases. Indian J Tuberc 2019; 66:431-432. [PMID: 31813427 DOI: 10.1016/j.ijtb.2019.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- K K Chopra
- New Delhi Tuberculosis Centre, Indian Journal of Tuberculosis, New Delhi, India.
| | - V K Arora
- TB Association of India, Indian Journal of Tuberculosis, India
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22
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Sharma A, Ahuja S, Diwaker P, Wadhwa N, Arora VK. Acinic cell carcinoma of the parotid gland: A diagnostic dilemma on cytology. Malays J Pathol 2019; 41:191-194. [PMID: 31427555] [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: 06/10/2023]
Abstract
INTRODUCTION Acinic cell carcinoma (ACC) represents 1-6% of parotid gland neoplasms. CASE REPORT We report cytomorphological features of two uncommon variants of acinic cell carcinoma. The first case was an eleven-year-old female with a nodular mass in parotid and the FNA smears demonstrated a lymphoepithelial lesion composed of epithelial tumour cells with features of acinar cells in a lymphoid background. The second case was a 62-year-old male with a large parotid mass. The FNA smears revealed presence of extracellular, acellular amyloid-like material with tumour cells arranged in follicles. DISCUSSION Awareness of cytomorphological features of these unusual variants of acinic cell carcinoma may help to avoid diagnostic pitfall.
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Affiliation(s)
- A Sharma
- University College of Medical Sciences, Department of Pathology, Delhi, India.
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Chopra KK, Arora VK. Geriatric TB: Needs focussed attention under RNTCP. Indian J Tuberc 2019; 66:323-324. [PMID: 31439174 DOI: 10.1016/j.ijtb.2019.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- K K Chopra
- New Delhi Tuberculosis Centre, New Delhi, India; Indian Journal of Tuberculosis, India.
| | - V K Arora
- TB Association of India, India; Indian Journal of Tuberculosis, India
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Affiliation(s)
- K K Chopra
- New Delhi Tuberculosis Centre, New Delhi, India; Indian Journal of Tuberculosis, India.
| | - V K Arora
- TB Association of India, India; Indian Journal of Tuberculosis, India
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Arora VK, Chandra K, Chandra M. Occupational tuberculosis in sewage workers: A neglected domain. Indian J Tuberc 2019; 66:3-5. [PMID: 30797278 DOI: 10.1016/j.ijtb.2018.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 09/14/2018] [Indexed: 06/09/2023]
Affiliation(s)
- V K Arora
- Santosh University, Ghaziabad, Uttar Pradesh, India
| | | | - Mina Chandra
- Department of Psychiatry, PGIMER and Dr RML Hospital, New Delhi, India
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Chopra KK, Hanif K M M, Arora VK, Vashistha H. Can sputum microscopy be replaced? Indian J Tuberc 2018; 65:275-276. [PMID: 30522611 DOI: 10.1016/j.ijtb.2018.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 08/30/2018] [Indexed: 06/09/2023]
Affiliation(s)
- K K Chopra
- New Delhi Tuberculosis Centre, New Delhi, India; Indian Journal of Tuberculosis, India.
| | - M Hanif K M
- New Delhi Tuberculosis Centre, New Delhi, India
| | - V K Arora
- TB Association of India, India; Indian Journal of Tuberculosis, India
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Bute J, Kori S, Arora VK, Sahasrabuddhe A. Prevalence and pattern of alcohol consumption among males attending primary health care setting using AUDIT in rural Indore, Madhya Pradesh, India. ACTA ACUST UNITED AC 2018. [DOI: 10.18203/2394-6040.ijcmph20183994] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: Alcohol consumption is one of the public health problems in India which acts as major attributable risk factor for majority of morbidity and mortality among adults. The objectives of the study were to find out the prevalence of alcohol consumption and its associated factors in rural area by using a WHO tool, AUDIT (Alcohol Use Disorder Identification Test) and to identify extent and pattern of alcohol consumption.Methods: This study was cross-sectional study. Three hundred sixty four male patients ≥15 years of age, attending OPD in a primary health care setting were interviewed by using a structured questionnaire and AUDIT.Results: The overall prevalence of ever consumed alcohol was found to be 49.7%; of which 38.2% were current drinkers and 11.5% were former drinkers while rest 50.3% were life time abstainers. Educational status, occupation, tobacco use and positive family history were significantly associated with alcohol consumption; while type and size of family, socioeconomic status were found insignificant association. About 53.9% preferred country-made liquor while 23.8% Indian Made Foreign Liquor (IMFL). Enjoyment (45.3%), relaxation or stress buster or social cause (29.5%), peer pressure (25.2%) being the reasons for alcohol consumption. In 33% of consumers, daily drinking and in 36% consumers, 1-5 times per week frequency for alcohol drinking was seen respectively. Three fourth of them purchased alcohol from local shops. Out of 364 subjects 75% belongs to AUDIT score of low risk, 11.2% with alcohol use in excess of low risk, 3.6% with harmful and hazardous drinking and 10.2% with dependent drinking.Conclusions: In our study, alcoholism is found to be more common among illiterates, non-formers, among tobacco users and those having positive family history. Socio economic status and age is not the bar for alcohol consumption.
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Affiliation(s)
- V K Arora
- Vice Chairman (P&R), TB Association of India, India; Executive Editor, Indian Journal of Tuberculosis, India
| | - K K Chopra
- Director, New Delhi Tuberculosis Centre, New Delhi, India; Associate Executive Editor, Indian Journal of Tuberculosis, India.
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Wadhwa N, Diwaker P, Lotha N, Arora VK, Singh N. Cytokeratin 20 immunocytochemistry on urine sediments: A potential low-cost adjunct to cytology in the diagnosis of low-grade urothelial carcinoma. Cytopathology 2017; 28:531-535. [PMID: 28940433 DOI: 10.1111/cyt.12463] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Urine cytology is the corner-stone for the diagnosis of urothelial neoplasia; however, a substantial proportion of low-grade carcinomas are reported as inconclusive owing to scant cellularity and subtle cytological features. Biomarkers applied on urine sediment smears of such patients are likely to be clinically relevant. Access to Food and Drug Administration approved urinary biomarkers in resource limited setting is poor. Detection of cytokeratin 20 (CK20) in urine sediments, although still a research tool, is a promising marker as immunocytochemistry is performed regularly in several Indian laboratories. OBJECTIVE We tested the clinical utility of CK20 immunocytochemistry as a potential low-cost adjunct to urine cytology in diagnosis of low-grade urothelial carcinoma. One hundred and fifty fresh, voided urine specimens from 42 cases of biopsy proven urothelial neoplasia (14 high grade, 28 combined low-grade [n=26]) and low malignant potential [n=2]), and 20 non-neoplastic lesions were included in the study sample. RESULTS Confident diagnosis of malignancy was possible in five (17.8%) low-grade malignancies. Thirteen of 16 (81.3%) low-grade malignancies with inconclusive cytology showed positive CK20 expression. This reduced the proportion of low-grade cases with inconclusive cytology from 57.1% to 10.7% (P=.021). In addition, we could correctly classify one case of bladder lithiasis with false positive urine cytology. Discrepant CK20 staining (positive) was seen in one patient with acute cystitis. CONCLUSIONS CK20 expression in non-umbrella cells is a robust marker of urinary bladder carcinoma. It has potential clinical utility for identification of low-grade urothelial malignancy with inconclusive cytological diagnosis.
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Affiliation(s)
- N Wadhwa
- Department of Pathology, University College of Medical Sciences, University of Delhi, Shahdra, Delhi, India
| | - P Diwaker
- Department of Pathology, University College of Medical Sciences, University of Delhi, Shahdra, Delhi, India
| | - N Lotha
- Department of Pathology, University College of Medical Sciences, University of Delhi, Shahdra, Delhi, India
| | - V K Arora
- Department of Pathology, University College of Medical Sciences, University of Delhi, Shahdra, Delhi, India
| | - N Singh
- Department of Pathology, University College of Medical Sciences, University of Delhi, Shahdra, Delhi, India
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Arora VK, Chopra KK. India's approach to the standards of TB care. Indian J Tuberc 2017; 64:1-4. [PMID: 28166909 DOI: 10.1016/j.ijtb.2017.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- V K Arora
- Vice Chairman (P&R), TB Association of India, India; Executive Editor, Indian Journal of Tuberculosis, India
| | - K K Chopra
- Director, New Delhi Tuberculosis Centre, New Delhi, India; Associate Executive Editor, Indian Journal of Tuberculosis, India.
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Kava S, Rajaram S, Arora VK, Goel N, Aggarwal S, Mehta S. Conventional cytology, visual tests and evaluation of P16(INK4A) as a biomarker in cervical intraepithelial neoplasia. Indian J Cancer 2016; 52:270-5. [PMID: 26905107 DOI: 10.4103/0019-509x.176729] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES (1) To detect cervical intraepithelial neoplasia (CIN) using Papanicolaou test (PAP test), visual tests (visual inspection after the application of acetic acid [VIA], visual inspection after the application of Lugol's iodine [VILI]), colposcopy, and biopsy. (2) To study the biomarker p16(INK4A) expression by immunostaining. MATERIALS AND METHODS Experimental study was conducted from November 2009 to April 2011. 1500 women were screened for cancer cervix using conventional PAP test, VIA, and VILI. Sensitivity, specificity, positive, and negative predictive values of these tests were calculated individually, sequentially, and in parallel. Women having positive results underwent colposcopy and biopsy if required. p16(INK4A) expression in biopsy samples was studied using immunohistochemistry. RESULTS All test positive cases (n = 235) underwent colposcopy. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PAP with atypical squamous cells of undetermined significance (ASCUS) as cut-off was 40%, 99.25%, 35.25%, and 99.39%; VIA was 60%, 93.06%, 8.03%, and 99.56% and VILI was 80%, 86.06%, 5.4%, and 99.76%, respectively. When PAP, VIA, and VILI were used in parallel sensitivity, specificity, PPV, and NPV improved to 100%, 85.18%, 6.38%, and 100%, respectively. Colposcopic abnormalities were detected in 83 and biopsy proven CIN in 15. p(16INK4A) expression was seen in eight of 15 CIN cases. CONCLUSIONS (1) PAP test and visual techniques are complementary. (2) p(16INK4A) expression was seen in majority of CIN 2 lesions suggesting a higher grade lesion.
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Affiliation(s)
| | - S Rajaram
- Department of Obstetrics and Gynecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Singal A, Daulatabad D, Pandhi D, Arora VK. Facial Basal Cell Carcinoma Treated with Topical 5% Imiquimod Cream with Dermoscopic Evaluation. J Cutan Aesthet Surg 2016; 9:122-5. [PMID: 27398014 PMCID: PMC4924409 DOI: 10.4103/0974-2077.184040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Basal cell carcinoma (BCC) is the most common skin cancer worldwide. Surgical excision is considered to be the primary therapeutic modality wherever possible. For inoperable cases, 5% imiquimod seems to be a good alternative. We present two cases of nodular pigmented BCCs on the face in elderly women successfully treated with 5% imiquimod cream application resulting in complete clinical clearance of lesion as well as on histology and dermatoscopy. There was no recurrence of the lesion on 2 years follow-up for the first and 1.5 years for the second patient.
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Affiliation(s)
- Archana Singal
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, University of Delhi, New Delhi, India
| | - Deepashree Daulatabad
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, University of Delhi, New Delhi, India
| | - Deepika Pandhi
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, University of Delhi, New Delhi, India
| | - V K Arora
- Department of Pathology, University College of Medical Sciences and GTB Hospital, University of Delhi, New Delhi, India
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Arora VK, Singh N. Viewpoint: Is it right time for undergraduate curriculum change based on our National Health Programmes--Tuberculosis Programme a perfect example? Indian J Tuberc 2015; 62:64-65. [PMID: 26117473 DOI: 10.1016/j.ijtb.2015.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- V K Arora
- Vice Chancellor, Santosh University, Ghaziabad, India.
| | - Narendra Singh
- Associate Professor, Department of Community Medicine, Santosh Medical College, Ghaziabad, India
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Dhawan A, Bisherwal K, Arora VK, Gandhi V. Incontinentia pigmenti in a male neonate: An Indian perspective. Indian J Paediatr Dermatol 2015. [DOI: 10.4103/2319-7250.165617] [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: 11/04/2022] Open
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Chachra V, Arora VK. Author's response. Indian J Tuberc 2014; 61:345. [PMID: 25682613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Rajpal S, Arora VK. Molecular diagnostics in tuberculosis revisited with clinicians' perspective. Indian J Tuberc 2014; 61:277-280. [PMID: 25675688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Batra J, Arora VK. Oxidative stress and tuberculosis. Indian J Tuberc 2014; 61:183-185. [PMID: 25241564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Karim A, Arora VK. Applications of ultrasonography in respiratory intensive care. Indian J Chest Dis Allied Sci 2014; 56:27-31. [PMID: 24930204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Emerging evidence suggests that ultrasonography of lung is a fast, inexpensive, widely available bed-side diagnostic tool which is useful for quick and early diagnosis of respiratory diseases. It is useful in the differential diagnosis of pulmonary infiltrates and has good accuracy in identifying consolidation and alveolar-interstitial syndrome. This technique can also be useful in the immediate evaluation of patients with dyspnoea or acute respiratory failure in the respiratory intensive care unit and helps in monitoring treatment response. Ultrasonography of lung has also been found to be useful in the diagnosis of pulmonary embolism, traumatic lung contusion and lung consolidation as well. There is a need for developing specific guidelines for establishing the standards of training and education regarding lung ultrasonography in India.
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Arora VK, Chopra KK. Changing role of Tuberculosis Association of India in 75 years. Indian J Tuberc 2014; 61:1-4. [PMID: 24640337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Singla R, Arora VK. Multi-drug resistant tuberculosis in India. Indian J Tuberc 2014; 61:9-11. [PMID: 24640339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Chachra V, Arora VK. Study on prevalance of diabetes mellitus in patients with T.B. under DOTS strategy. Indian J Tuberc 2014; 61:65-71. [PMID: 24640347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Tuberculosis is five to six times more common among diabetics than among non-diabetics and causes greater morbidity, according to reports. The effective control of each affects the control of the other. Diabetes increases the risk of developing tuberculosis, especially in developing countries with a high incidence of tuberculosis. DOTS strategy has been an effective tool on a mass basis. However, patients under DOTS are not screened for diabetes before the therapy. AIMS & OBJECTIVES To study the prevalence of diabetes mellitus in patients with tuberculosis under DOTS strategy. MATERIAL & METHODS A cross-sectional study was conducted in Santosh Medical College & Hospital, Ghaziabad, with the patients taken from different DOTS centres of NCR-Delhi, India. The present study was undertaken to evaluate the presence of undiagnosed diabetes under DOTS strategy. Fasting capillary blood glucose levels of patients diagnosed with tuberculosis were analyzed and were managed as per DOTS guidelines at multiple centres in the northwest region of India. RESULTS We studied 700 patients. The prevalence of diabetes was 12.6% (n=88), which is quite high. When category-wise analysis of diabetic subjects was done, it was found that patients under Category-I were 11.7% (n=47), patients under Cat-II were 15.5% (n=39) and those under Cat-III were 3.9% (n=2). The higher percentage of patients in Cat-II indicates the poor outcome of Cat-I patients, probably due to diabetes as a co-morbid disease. CONCLUSION The higher prevalence of diabetes mellitus in DOTS patients raises immediate concerns in preventing the morbidity due to both the diseases. Therefore, it is recommended that some strategy on the lines of HIV disease should be formed under DOTS for the concomitant treatment of TB and diabetes for better outcome and care.
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Arora VK, Jaiswal AK, Jain V. Changing trends of cutaneous tuberculosis in the era of DOTS strategy. Indian J Tuberc 2012; 59:116-118. [PMID: 22838212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- V K Arora
- Santosh University, Ghaziabad, Uttar Pradesh.
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Arora VK, Chachra V. Stem cells and its importance in respiratory medicine with special reference to tuberculosis. Indian J Tuberc 2011; 58:1-3. [PMID: 21434550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Christian JR, Arora VK, Boer GJ, Curry CL, Zahariev K, Denman KL, Flato GM, Lee WG, Merryfield WJ, Roulet NT, Scinocca JF. The global carbon cycle in the Canadian Earth system model (CanESM1): Preindustrial control simulation. ACTA ACUST UNITED AC 2010. [DOI: 10.1029/2008jg000920] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Dhingra VK, Hanif M, Mittal A, Gupta S, Rajpal S, Agarwal N, Arora VK. Study of different methods of susceptibility testing of M. tuberculosis. J Commun Dis 2010; 42:111-121. [PMID: 22471170] [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: 05/31/2023]
Abstract
This communication is on a multi-centre collaborative study carried out by New Delhi Tuberculosis (NDTB) Centre, Delhi, to compare the different methods of drug susceptibility testing (DST) of Mycobacterium tuberculosis for Streptomycin, Rifampicin, Isoniazid and Ethambutol in various accredited laboratories 40 samples (selected by simple random sampling technique) from sputum positive out-patients presenting between December 2004 and January 2005 were collected at New Delhi Tuberculosis Centre from 24 males and 16 females (age ranging from 18 to 55 years) were taken up for culture and susceptibility testing. The proportion method of DST done at NDTB Centre was taken as standard for comparing the other methods after it was found to have a good agreement with the proportion method performed at Tuberculosis Research Centre, Chennai (Kappa coefficient 0.75 to 1). All 40 sub-cultures were processed for DST by the resistance ratio and proportion methods at NDTB Centre. Also, the 40 sub-cultures were sent to Central JALMA Institute for Leprosy (JALMA), Agra that used the resistance ratio method and 25 sub-cultures were transported to National Institute of Communicable Diseases (NICD), Delhi for performing the Bactec 460TB method. The resistance ratio and proportion methods were compared both intra-laboratory (NDTB Centre) and inter-laboratory (NDTB Centre and JALMA). The sensitivity and specificity of the resistance ratio method compared to the proportion method both inter and intra-laboratory, were very high for all the drugs (except Ethambutol inter-laboratory). This was corroborated by the good agreement between the resistance ratio performed at the two centres. Bactec 460TB method, on the other hand, did not have acceptable measures of validity (sensitivity and specificity) compared to the proportion method for Streptomycin and Ethambutol. Both resistance ratio method & proportion method are comparable and either can be used for making clinical decisions. But Bactec 460 method, despite yielding early results loses out on validity.
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Dhingra VK, Malik S, Hanif M, Arora VK. XDR Tuberculosis: a report from the New Delhi Tuberculosis Centre, India. J Coll Physicians Surg Pak 2009; 19:133-5. [PMID: 19208323 DOI: 02.2009/jcpsp.133135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Received: 04/24/2008] [Accepted: 11/14/2008] [Indexed: 12/01/2022]
Affiliation(s)
- V K Dhingra
- New Delhi Tuberculosis Centre, New Delhi, India.
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Sharma SG, Mathur SR, Aron M, Iyer VK, Arora VK, Verma K. Chromophobe renal cell carcinoma with calcification: Report of a case with rare finding on aspiration smears. Diagn Cytopathol 2008; 36:647-50. [PMID: 18677748 DOI: 10.1002/dc.20861] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Chromophobe renal cell carcinoma (ChRCC) is a distinct variant of renal cell carcinoma. It is important to identify this entity because it has a significantly better prognosis than clear cell (conventional) renal cell carcinoma. We report the case of a 56-year-old male who presented with 10 days history of painless hematuria. There was no palpable swelling or systemic symptoms. On radiological examination the possibility of a right renal neoplasm was considered. Ultrasound guided aspiration was done and cytological features of ChRCC were noted. In addition, numerous foci of calcification were seen, which was an unusual cytological feature for ChRCC. The characteristic cytomorphology of ChRCC makes it possible to render a preoperative diagnosis on fine needle aspiration cytology (FNAC). We report the case to emphasize the importance and possibility of diagnosing of ChRCC on cytology. In addition, the extensive calcification as seen in our case is an unusual cytological finding not previously reported in cytology smears.
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Affiliation(s)
- Shree Gopal Sharma
- Cytopathology Laboratory, Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India
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Arora VK, Singla R, Dhingra VK, Prasad R. Panel discussion on MDR and XDR TB. Moderated by Dr. V.K. Arora. Indian J Tuberc 2008; 55:104-109. [PMID: 18516829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- V K Arora
- Santosh Medical College & Hospital, Ghaziabd.
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Dhingra VK, Rajpal S, Mittal A, Gupta UA, Arora VK. Tuberculosis of the ilium: a case report. J Commun Dis 2008; 40:79-82. [PMID: 19127675] [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: 05/27/2023]
Abstract
A twenty year old man presented with pain in the upper part of right hip. CT scan showed multiple osteolytic areas in the right ilium, suggesting malignancy. CT guided needle biopsy was done and diagnosis of tuberculosis was made. The patient was cured with medical management only. Isolated tuberculosis of the ilium is an extremely rare condition. It is important to have a high clinical suspicion to diagnose early and manage the patient without surgical intervention.
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Affiliation(s)
- V K Dhingra
- New Delhi Tuberculosis Centre, Jawaharlal Nehru Marg, New Delhi
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