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Jain BK, Jain E. Rural development through eye care: A new dimension of possibilities. Indian J Ophthalmol 2023; 71:330-334. [PMID: 36727313 DOI: 10.4103/ijo.ijo_105_23] [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: 02/03/2023] Open
Affiliation(s)
- B K Jain
- Director and Trustee, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Jankikund, Chitrakoot, District Satna, Madhya Pradesh, India
| | - Elesh Jain
- Director and Trustee, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Jankikund, Chitrakoot, District Satna, Madhya Pradesh, India
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Shakya R, Ahluwalia NS, Shah C, Paul P, Jain BK, Pandit K, Gupta RKC, Ahlawat R, Choudhary P. Awareness and knowledge among paramedical staff about glaucoma surgeries and post-surgery counseling - A questionnaire based study at a tertiary eye care center in Central Rural India. Indian J Ophthalmol 2023; 71:580-584. [PMID: 36727365 DOI: 10.4103/ijo.ijo_1766_22] [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: 02/03/2023] Open
Abstract
Purpose To determine the level of awareness and knowledge about glaucoma surgery and post-surgery counseling amongst paramedical staff at a tertiary eye-care hospital. Methods This observational cross-sectional study included a random sample of 94 hospital personnel: 37 general nurse midwives, 47 ophthalmic assistants, and 10 patient caretakers (PCTs). Participants were administered a questionnaire about glaucoma surgery and post-surgery counseling of patients. Results The study included 41 (43.6%) females and 53 (56.4%) males. The mean age of the participants was 24.85 ± 4.54 years. All participants were aware of trabeculectomy surgery in glaucoma (100%). A total of 95.7% knew that surgery helps in controlling IOP, of whom 57 (60.6%) participants got information during their course of learning. Overall 53 (56.4%) believed that surgery is done when medication failure occurs, and 58 (61.7%) knew that surgery helps in preserving vision. A total of 63 (67.0%) participants knew to counsel patients to visit an ophthalmologist when called for and take the treatment as advised, whereas 74 (78.7%) correctly said to visit an ophthalmologist immediately if pain/diminution of vision/discharge occurs. Overall, PCTs were found to be having significantly better knowledge (P = 0.01) compared to others and they also reported ophthalmologists as the chief source of information. Conclusion This study revealed that paramedical staff had an excellent awareness of trabeculectomy surgery. However, the knowledge and counseling parts of the questionnaire revealed less than satisfactory responses. So, there is a need to continuously educate paramedical staff members so that they can help in propagating information about the role of glaucoma surgery and the importance of proper follow-up.
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Affiliation(s)
- Rakesh Shakya
- Department of Glaucoma, Sadguru Netra Chikitsalaya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Navjot Singh Ahluwalia
- Department of Glaucoma, Sadguru Netra Chikitsalaya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Chintan Shah
- Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Pulak Paul
- Department of Glaucoma, Sadguru Netra Chikitsalaya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - B K Jain
- Director and Trustee, Quality Assurance, Sadguru Netra Chikitsalaya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Kushal Pandit
- Department of Glaucoma, Sadguru Netra Chikitsalaya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Ramesh K C Gupta
- Department of Glaucoma, Sadguru Netra Chikitsalaya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Reena Ahlawat
- Department of Glaucoma, Sadguru Netra Chikitsalaya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
| | - Priyanka Choudhary
- Department of Glaucoma, Sadguru Netra Chikitsalaya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Madhya Pradesh, India
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Jain BK, Songara A, Chandrakantham UM, Nagwanshi J. Effect of smoking on vital hemodynamic parameters and lipid profile of young smokers. IMC Journal of Medical Science 2022. [DOI: 10.55010/imcjms.17.007] [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: 11/23/2022] Open
Abstract
Background and objectives: Tobacco use is associated with cardiovascular, respiratory and peripheral vascular diseases. The short term effects of tobacco smoking on vital hemodynamic parameters and lipid profile of young smoker with increased quantity of smoking is still debatable. The objective of this study was to evaluate the effect of smoking on vital hemodynamic parameters and lipid profile of young smokers.
Materials and methods: The current study was an observational cross sectional study conducted in a tertiary care hospital over a period of 18 months and included smokers and non-smokers. Data on vital hemodynamic parameters like blood pressure, heart rate, oxygen saturation (SPO2) and lipid profile were collected. Chi-square and analysis of variance (ANOVA) tests were used to analyze the data.
Results: A total of 80 smokers and 80 non-smokers were enrolled in the study. Blood pressure, heart rate and mean SpO2 were significantly (p<0.001) lower in non-smokers compared to smokers. Breath holding time (BHT) and single breath count (SBC) were higher in non-smokers. Mean values of total cholesterol (T-chol), low density lipoprotein (LDL) and triglyceride (TG) were significantly (p<0.001) higher in smokers than non-smokers, while high density lipoprotein (HDL) was significantly low in smokers. SBP, T -chol and TG significantly (p<0.05) increased as the quantity of smoking increased.
Conclusion: Smoking is associated with derangement of vital hemodynamic parameters and lipid profile across the age. Anti-smoking campaign should be organized to discourage both personal smoking and smoking in public places.
IMC J Med Sci. 2023. 17(1): 007. DOI : https://doi.org/10.55010/imcjms.17.007
*Correspondence: Bhupendra Kumar Jain, Department of Pulmonary Medicine, School of Chhindwara Institute Of Medical Sciences, Jabalpur Medical University, Chhindwara, Madhya Pradesh, India. Email: drbhupendrakjain@gmail.com
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Affiliation(s)
- Bhupendra Kumar Jain
- Department of Pulmonary Medicine, School of Chhindwara Institute of Medical Sciences, Chhindwara, Jabalpur Medical University, Madhya Pradesh, India
| | - Ashwin Songara
- Department of Pulmonary Medicine, Amaltas Institute of Medical Sciences, Dewas, Jabalpur Medical University, Madhya Pradesh, India
| | - U Maheshwar Chandrakantham
- Department of Pulmonary Medicine, School of Chhindwara Institute of Medical Sciences, Chhindwara, Jabalpur Medical University, Madhya Pradesh, India
| | - Jyoti Nagwanshi
- Department of Medicine, School of Chhindwara Institute of Medical Sciences, Chhindwara, Jabalpur Medical University, Madhya Pradesh, India
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Shakya R, Ahluwalia NS, Shah C, Mohan A, Parmar G, Gupta A, Gupta RKC, Borde P, Jain BK. Gonioscopic angle evaluation and its correlation with graft survival and post-operative ocular hypertension in patients of Descemet's stripping endothelial keratoplasty. Indian J Ophthalmol 2022; 70:3298-3303. [PMID: 36018107 DOI: 10.4103/ijo.ijo_803_22] [Citation(s) in RCA: 2] [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] [Indexed: 11/05/2022] Open
Abstract
Purpose To evaluate the gonioscopic changes in patients receiving Descemet's stripping endothelial keratoplasty (DSEK) without pre-existing ocular hypertension (OHT) and to report its correlation with post-surgery OHT, graft survival, and visual outcomes. Methods Adult patients who underwent DSEK surgery from April 2014 to March 2018 with at least 2 years of follow-up were analyzed in this retrospective study. Demographic details, indication of DSEK, necessary anterior and posterior segment findings, and the post-DSEK OHT details were documented. Results A total of 58 patients (23 males and 35 females) with a mean age of 61.44 ± 8.8 years were included in the study. The most common etiology for DSEK surgery was pseudophakic bullous keratopathy in 47 eyes (81.03%). A total of 22.41% (13/58) eyes showed elevated intra-ocular pressure (IOP) following DSEK surgery. The most common cause of IOP elevation was steroid-induced OHT in seven eyes (12.06%). Gonioscopy examination revealed areas of peripheral anterior synechiae (PAS) in 17 (29.3%) eyes. OHT was found in 4/17 (23.5%) eyes having PAS. Three of these cases required trabeculectomy + goniosynechiolysis (GSL), and the fourth case required GSL alone to control IOP. These four cases also required repeat DSEK for failed grafts. The mean pre-operative best corrected visual acuity was 1.62 logMAR (range 1.17-1.77), which gradually improved to 0.79 logMAR (range 0.3-1.77) after 2 years (p < 0.00001). Conclusion PAS was found to be an important factor associated with post-DSEK ocular hypertension in our study. OHT in PAS cases required definitive surgical treatments to control IOP. It adversely affected the graft survival and in turn affected visual outcomes also.
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Affiliation(s)
- Rakesh Shakya
- Department of Glaucoma, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Satna, Madhya Pradesh, India
| | - Navjot Singh Ahluwalia
- Department of Glaucoma, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Satna, Madhya Pradesh, India
| | - Chintan Shah
- Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Satna, Madhya Pradesh, India
| | - Amit Mohan
- Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Satna, Madhya Pradesh, India
| | - Gautam Parmar
- Department of Cornea and Refractive Services, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Satna, Madhya Pradesh, India
| | - Amit Gupta
- Department of Glaucoma, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Satna, Madhya Pradesh, India
| | - Ramesh K C Gupta
- Department of Glaucoma, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Satna, Madhya Pradesh, India
| | - Prashant Borde
- Department of Cornea and Refractive Services, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Satna, Madhya Pradesh, India
| | - B K Jain
- Department of Quality Assurance, Sadguru Netra Chikitsalya and Postgraduate Institute of Ophthalmology, Jankikund, Chitrakoot, Satna, Madhya Pradesh, India
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Jain BK, Jain E, Kuyyadiyil S, Sen A, Sood D, Bajaj A. High volume and high quality eye care - Bridging the paradox. A unique rural based approach - The Chitrakoot model. Indian J Ophthalmol 2020; 68:294-298. [PMID: 31957711 PMCID: PMC7003577 DOI: 10.4103/ijo.ijo_61_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- B K Jain
- Director and Trustee, Quality Assurance, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Jankikund, Chitrakoot 210204, District Satna, Madhya Pradesh, India
| | - Elesh Jain
- Administrator and Trustee, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Jankikund, Chitrakoot 210204, District Satna, Madhya Pradesh, India
| | - Subeesh Kuyyadiyil
- Head, Center for Community Ophthalmology, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Jankikund, Chitrakoot 210204, District Satna, Madhya Pradesh, India
| | - Alok Sen
- Medical Superintendent, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Jankikund, Chitrakoot 210204, District Satna, Madhya Pradesh, India
| | - Devindra Sood
- Head, Research and Training, Quality Assurance, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Jankikund, Chitrakoot 210204, District Satna, Madhya Pradesh, India
| | - Asheesh Bajaj
- Head, Research and Training, Quality Assurance, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Jankikund, Chitrakoot 210204, District Satna, Madhya Pradesh, India
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Affiliation(s)
- Bhupendra Kumar Jain
- Departments of Surgery, Red Cross General, Maternity, and Child Welfare Hospital, Delhi, India
| | - Deepti Choudhary
- Departments of Obstetrics and Gynaecology, Red Cross General, Maternity, and Child Welfare Hospital, Delhi, India
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Bhatt S, Jain BK, Singh VK. Multi Detector Computed Tomography Fistulography In Patients of Fistula-in-Ano: An Imaging Collage. Pol J Radiol 2017; 82:516-523. [PMID: 29662582 PMCID: PMC5894016 DOI: 10.12659/pjr.901523] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/31/2016] [Indexed: 12/18/2022] Open
Abstract
Fistula-in-ano, or perianal fistula, is a challenging clinical condition for both diagnosis and treatment. Imaging modalities such as fistulography, anal endosonography, perineal sonography, magnetic resonance imaging (MRI), and computed tomography (CT) are available for its evaluation. MRI is considered as the modality of choice for an accurate delineation of the tract in relation to the sphincter complex and for the detection of associated complications. However, its availability and affordability is always an issue. Moreover, the requirement to obtain multiple sequences to depict the fistula in detail is cumbersome and confusing for the clinicians to interpret. The inability to show the fistula in relation to normal anatomical structures in a single image is also a limitation. Multi detector computed tomography fistulography (MDCTF) is an underutilized technique for defining perianal fistulas. Acquisition of iso-volumetric data sets with instillation of contrast into the fistula delineates the tract and its components. Post-processing with thin sections allows for a generation of good quality images for presentation in various planes (multi-planar reconstructions) and formats (volume rendered technique, maximum intensity projection). MDCTF demonstrates the type of fistula, its extent, whether it is simple or complex, and shows the site of internal opening and associated complications; all in easy to understand images that can be used by the surgeons. Its capability to represent the entire pathology in relation to normal anatomical structures in few images is a definite advantage. MDCTF can be utilized when MRI is contraindicated or not feasible. This pictorial review shares our initial experience with MDCT fistulography in evaluating fistula-in-ano, demonstrates various components of fistulas, and discusses the types of fistulas according to the standard Parks classification.
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Affiliation(s)
- Shuchi Bhatt
- Department of Radio-Diagnosis, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, New Delhi, India
| | - Bhupendra Kumar Jain
- Department of Surgery, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, New Delhi, India
| | - Vikas Kumar Singh
- Department of Radio-Diagnosis, University College of Medical Sciences (University of Delhi) and Guru Teg Bahadur Hospital, New Delhi, India
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Agrawal V, Joshi MK, Gupta AK, Jain BK. Wound Outcome Following Primary and Delayed Primary Skin Closure Techniques After Laparotomy for Non-Traumatic Ileal Perforation: a Randomized Clinical Trial. Indian J Surg 2017; 79:124-130. [PMID: 28442838 DOI: 10.1007/s12262-015-1438-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 12/28/2015] [Indexed: 11/24/2022] Open
Abstract
To study the effect of primary and delayed primary closure of skin incision on wound outcome in patients with non-traumatic ileal perforation, 68 patients of ileal perforation were studied in a prospective randomized clinical trial. Patients fulfilling inclusion criteria were divided into ileostomy and non-ileostomy groups, both of which were then randomized into two subgroups each depending on whether skin was closed primarily or in a delayed primary manner. Wound infection and dehiscence were the main outcome parameters studied. The data collected was analyzed using appropriate statistical tools taking significant p value at 5 %. Most patients were 21-30 years of age. Male:female ratio was 3.2:1. The overall incidence of wound infection was 63 %. Wound infection was strongly associated with the incidence of superficial wound dehiscence and total wound dehiscence that were 11.76 and 47 %, respectively. Mortality was 10.3 %. Methodology of wound closure has no significant impact on incidence of wound infection, wound dehiscence, and mortality, although the onset of wound complications is significantly delayed with delayed primary closure of the skin.
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Affiliation(s)
- Vivek Agrawal
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Mohit Kumar Joshi
- Department of Surgical Disciplines, All India Institute of Medical Sciences, New Delhi, India 110029
| | - Ashish Kumar Gupta
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Bhupendra Kumar Jain
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Garg PK, Goel A, Jain BK. Positron-Emission Tomography-Computed Tomography for Cancer Screening: Boon or Bane. Indian J Surg 2017; 79:84-85. [PMID: 28331277 DOI: 10.1007/s12262-016-1530-x] [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] [Received: 05/11/2016] [Accepted: 07/11/2016] [Indexed: 10/21/2022] Open
Affiliation(s)
- Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
| | - Aakanksha Goel
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
| | - Bhupendra Kumar Jain
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
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Anshuman R, Singh M, Jain BK, Verma N, Arora R. Correlation of Pirani score and Foot bimalleolar angle in the treatment of idiopathic congenital talipes equino varus by Ponseti method in infants. Acta Orthop Belg 2016; 82:861-865. [PMID: 29182130] [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: 06/07/2023]
Abstract
AIM Correlation of Pirani score and Foot bimalleolar (FBM) angle in the treatment of idiopathic congenital talipes equino varus (CTEV) by Ponseti method in infants. MATERIAL AND METHODS 35 feet with idiopathic CTEV deformity <1 year were prospectively treated by Ponseti method. Deformity evaluated each successive week of treatment by Pirani score and FBM angle. Feet were divided according to Pirani score in groups : one(0-2.0), two(2.5-4) and three(4.5-6). Correlation between mean Pirani score and mean FBM angle was evaluated every week and at follow up, firstly by using Pearson's and Spearman's correlation and then, after dividing data in groups by using ANOVA. RESULTS Correlation between Pirani score and FBM angle was statistically significant(p value <0.05). CONCLUSION Pirani score decreases and FBM angle increases with correction. Pirani score and FBM angle correlated in severity of deformity and correction achieved, thus FBM angle provides objective evidence of clubfoot deformity/improvement/deterioration.
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Jain BK, Garg PK. Re: Long-term results of the cutting seton for high anal fistula. ANZ J Surg 2016; 86:208. [PMID: 26940184 DOI: 10.1111/ans.13406] [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)
- Bhupendra Kumar Jain
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
| | - Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
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Affiliation(s)
- Bhupendra Kumar Jain
- Department of Surgery, Guru Teg Bahadur Hospital and University College of Medical Sciences, University of Delhi, Dilshad Garden, Delhi, 110095 India
| | - Pankaj Kumar Garg
- Department of Surgery, Guru Teg Bahadur Hospital and University College of Medical Sciences, University of Delhi, Dilshad Garden, Delhi, 110095 India
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Jain BK, Garg PK, Palmo D, Mohnaty D, Agrawal V. Anal symptoms to anal obliteration: quackery in proctology continues! ACTA ACUST UNITED AC 2015; 35:274-6. [PMID: 26349181 DOI: 10.7869/tg.235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Affiliation(s)
- Krittika Aggarwal
- Department of Surgery, University College of Medical Sciences & GTB Hospital, Delhi, India
| | - Bhupendra Kumar Jain
- Department of Surgery, University College of Medical Sciences & GTB Hospital, Delhi, India
| | - Naveen Sharma
- Department of Surgery, University College of Medical Sciences & GTB Hospital, Delhi, India
| | - Sunny Goel
- Department of Surgery, University College of Medical Sciences & GTB Hospital, Delhi, India
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Garg PK, Jain BK. New cancer drugs at the cost of bankruptcy: will the oncologist tell the patients the benefit in terms of days/weeks added to life? Oncologist 2015; 19:1291. [PMID: 25480341 DOI: 10.1634/theoncologist.2014-0263] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
| | - Bhupendra Kumar Jain
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
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Jain BK, Garg PK. Palliation for refractory anal fistula--an honorable respite. Int J Colorectal Dis 2015; 30:857-8. [PMID: 25388477 DOI: 10.1007/s00384-014-2064-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2014] [Indexed: 02/04/2023]
Affiliation(s)
- Bhupendra Kumar Jain
- Department of Surgery, Guru Teg Bahadur Hospital and University College of Medical Sciences (University of Delhi), Dilshad Garden, Delhi, India, 110095,
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Garg PK, Jain BK. Reduction of Adult Intussusception: More Harm Than Benefit. World J Surg 2015; 39:2606. [PMID: 25868765 DOI: 10.1007/s00268-015-3074-9] [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: 10/23/2022]
Affiliation(s)
- Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, 110095, India,
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Khandekar R, Sudhan A, Jain BK, Deshpande M, Dole K, Shah M, Shah S. Impact of cataract surgery in reducing visual impairment: a review. Middle East Afr J Ophthalmol 2015; 22:80-5. [PMID: 25624679 PMCID: PMC4302482 DOI: 10.4103/0974-9233.148354] [Citation(s) in RCA: 9] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose: The aim was to assess the impact of cataract surgeries in reducing visual disabilities and factors influencing it at three institutes of India. Materials and Methods: A retrospective chart review was performed in 2013. Data of 4 years were collected on gender, age, residence, presenting a vision in each eye, eye that underwent surgery, type of surgery and the amount the patient paid out of pocket for surgery. Visual impairment was categorized as; absolute blindness (no perception of light); blind (<3/60); severe visual impairment (SVI) (<6/60-3/60); moderate visual impairment (6/18-6/60) and; normal vision (≥6/12). Statistically analysis was performed to evaluate the association between visual disabilities and demographics or other possible barriers. The trend of visual impairment over time was also evaluated. We compared the data of 2011 to data available about cataract cases from institutions between 2002 and 2009. Results: There were 108,238 cataract cases (50.6% were female) that underwent cataract surgery at the three institutions. In 2011, 71,615 (66.2%) cases underwent surgery. There were 45,336 (41.9%) with presenting vision < 3/60 and 75,393 (69.7%) had SVI in the fellow eye. Blindness at presentation for cataract surgery was associated to, male patients, Institution 3 (Dristi Netralaya, Dahod) surgeries after 2009, cataract surgeries without Intra ocular lens implant implantation, and patients paying <25 US $ for surgery. Predictors of SVI at time of cataract surgery were, male, Institution 3 (OM), phaco surgeries, those opting to pay 250 US $ for cataract surgeries. Conclusion: Patients with cataract seek eye care in late stages of visual disability. The goal of improving vision related quality of life for cataract patients during the early stages of visual impairment that is common in industrialized countries seems to be non-attainable in the rural India.
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Affiliation(s)
- Rajiv Khandekar
- Department of Research, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Anand Sudhan
- Department of Research, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - B K Jain
- Department of Research, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Madan Deshpande
- Department of Research, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Kuldeep Dole
- Department of Research, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Mahul Shah
- Department of Research, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Shreya Shah
- Department of Research, King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia
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Jain BK, Bansal A, Choudhary D, Garg PK, Mohanty D. Centchroman vs tamoxifen for regression of mastalgia: a randomized controlled trial. Int J Surg 2015; 15:11-6. [PMID: 25619124 DOI: 10.1016/j.ijsu.2014.12.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 04/18/2014] [Revised: 10/29/2014] [Accepted: 12/26/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Several agents have been tried in the management of mastalgia. Centchroman (Ormeloxifene), a novel non-steroidal selective estrogen receptor modulator (SERM), has also been recently used in the management of mastalgia. METHODS Eligible patients, who had mastalgia for more than 3 months, were randomized into two groups - Group A received centchroman 30 mg daily and Group B received tamoxifen 10 mg daily. Treatment was continued for a total of 12 weeks; thereafter, patients were followed for another 12 weeks without medication to assess the continuum of relief. Pain severity was measured with VAS score. Patients were considered to have complete pain relief if their VAS score decreased to 3 or less. RESULTS Patients, in both the groups, showed gradual improvement in mastalgia with passage of time up to 12 weeks. Following cessation of treatment at 12 weeks, partial relapse of pain was observed at 24 weeks. There was no significant difference between Group A and Group B in terms of mean VAS Score and proportion of women reporting pain relief at 4, 8, 12, and 24 weeks. Fifteen patients in Group A had side effects namely dizziness, menstrual irregularities and development of ovarian cysts. There was no side effect noted in group B. CONCLUSION Centchroman and tamoxifen were found to be of similar effectiveness in providing pain relief in mastalgia. High frequency of side effects, particularly development of ovarian cyst, in patients receiving centchroman is a matter of concern.
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Affiliation(s)
- Bhupendra Kumar Jain
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India.
| | - Amit Bansal
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
| | - Deepti Choudhary
- Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
| | - Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India; Department of Surgical Oncology, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Debajyoti Mohanty
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
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Jain BK, Garg PK. Triple procedure for complex anal fistula. Tech Coloproctol 2014; 19:47-50. [PMID: 25359696 DOI: 10.1007/s10151-014-1228-7] [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] [Received: 09/18/2014] [Accepted: 10/06/2014] [Indexed: 11/24/2022]
Affiliation(s)
- B K Jain
- Department of Surgery, Guru Teg Bahadur Hospital and University College of Medical Sciences, University of Delhi, Delhi, 110095, India,
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Jain BK, Sharma P, Bajpai A, Motiwale S, Pasari N, Patel D. Role of fibreoptic bronchoscopy and CT guided FNAC in diagnostic evaluation of Non resolving Pneumonia with special emphasis on clinical outcome. Asian J Med Sci 2014. [DOI: 10.3126/ajms.v6i3.10727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Nonresolving pneumonia is a pneumonia with a delayed or slow resolution of radiographic infiltrates or clinical symptoms despite adequate treatment with antibiotics for a minimum period of 10 days. Fibreoptic bronchoscopy (FOB) and CT guided FNAC has a specific role in diagnosis of Non resolving pneumonia. Aims and Objectives: To assess the diagnostic efficacy of fibreoptic bronchoscopy (FOB) and computed tomography (CT)- guided fi ne needle aspiration cytology (FNAC) in evaluation of non-resolving or slowly resolving pneumonia with special emphasis on clinical outcome. Material and Methods: The study was designed as a prospective observational study. We reviewed FOB in Sixty-five consecutive patients of Non-resolving pneumonia admitted under Respiratory Medicine unit of Sri aurobindo medical college and PG Institute Indore from June 2012 to May 2014. We also reviewed role of CT guided FNAC in selected case where FOB result was inconclusive. Result: Out of total Sixty-five case of non resolving pneumonia, Fifty-two patient (81%) were diagnosed with the help of FOB and Eleven patients (91%) were diagnosed with help of CT guided FNAC out of Twelve patient subjected for procedure. Conclusion: FOB should be the first option before CT-guided FNAC in evaluating non-resolving pneumonia. Both the procedures were safe and no major complication was observed. DOI: http://dx.doi.org/10.3126/ajms.v6i3.10727 Asian Journal of Medical Sciences Vol.6(3) 2015 66-71
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Garg PK, Jain BK, Dahiya D, Bhatt S, Arora VK. Mesenteric liposarcoma: report of two cases with review of literature. J Gastrointest Cancer 2014; 45 Suppl 1:170-4. [PMID: 24781302 DOI: 10.1007/s12029-014-9612-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Dilshad Garden, Delhi, 110095, India,
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Garg PK, Mohanty D, Rathi V, Jain BK. Spontaneous rupture of the renal pelvis presenting as an urinoma in locally advanced rectal cancer. World J Clin Cases 2014; 2:108-110. [PMID: 24749123 PMCID: PMC3985039 DOI: 10.12998/wjcc.v2.i4.108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Revised: 01/26/2014] [Accepted: 02/20/2014] [Indexed: 02/05/2023] Open
Abstract
A 29-year-old gentleman underwent a transverse colostomy for intestinal obstruction caused by advanced rectal carcinoma. On the 5th postoperative day, the patient developed a painful swelling on the right side of the abdomen. The contrast enhanced computed tomography of the abdomen revealed a right sided hydronephrosis, a large rent in the renal pelvis, and a large retroperitoneal fluid collection on the right side. Percutaneous nephrostomy and pigtail catheter drainage of the urinoma led to resolution of abdominal swelling. Development of a urinoma as a consequence of rectal carcinoma is highly unusual. Prompt imaging for confirmation of diagnosis, decompression of the renal pelvicalyceal system, and drainage of the urinoma limits morbidity.
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Mohanty D, Garg PK, Kumar A, Jain BK. Abdominal lump with intestinal obstruction: prior history of abdominal surgery is a clue to diagnosis. Ann Afr Med 2014; 13:95-6. [PMID: 24705116 DOI: 10.4103/1596-3519.129893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
| | - Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences, and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
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Agrawal V, Garg PK, Jain BK, Mishra K, Mohanty D. Amoebic anal fistula: new insight into an old disease. Acta Med Indones 2014; 46:131-133. [PMID: 25053686] [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: 06/03/2023]
Abstract
A 67-year-old gentleman underwent fistulectomy for low trans-sphincteric anal fistula along with curettage for an associated abscess extending proximally for half a centimeter into the intersphincteric plane. The roof of the cavity became clearly visible after satisfactory culmination of the surgical procedure. Histopathological examination of the fistulous tract and the curetted granulation tissue revealed presence of multiple trophozoites of Entamoeba histolytica exhibiting erythrophagocytosis in the background of mixed inflammatory infiltrate. This case report provides the outlook that yields the novel insight into the possible role of Entamoeba histolytica in the pathogenesis and persistence of the fistulous tract.
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Affiliation(s)
- Vivek Agrawal
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, New Delhi, India
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Garg PK, Mohnaty D, Jain BK, Goel S, Singh B. Giant subcutaneous synovial sarcoma: an interesting case. J Clin Diagn Res 2014; 7:3014-5. [PMID: 24551714 DOI: 10.7860/jcdr/2013/6408.3833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 05/05/2013] [Accepted: 09/18/2013] [Indexed: 11/24/2022]
Abstract
A 45-year-old lady presented to us with a large subcutaneous swelling on her left side of back of 1 year duration. Local examination revealed a 13×12 cm spherical swelling on the left lower paraspinal region. Magnetic resonance imaging of lumbosacral spine revealed a 13×12 cm mass having solid and cystic components with internal septations in the subcutaneous tissue of left posterior paraspinal area. The mass was hetrogenously hyperintense on T 2 weighted images suggestive of synovial sarcoma. Wide local excision of the lump was carried out followed by closure of the defect with a lateral intercostal artery based rotational flap. The histopathology of the excised tumor revealed synovial sarcoma that stained positive for cytokeratin and epithelial membrane antigen. This case highlights an unusually large subcutaneous synovial sarcoma present in para-spinal area.
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Affiliation(s)
- Pankaj Kumar Garg
- Assistant Professor, Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi , Delhi, India
| | - Debajyoti Mohnaty
- Assistant Professor, Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi , Delhi, India
| | - Bhupendra Kumar Jain
- Director Professor and Head, Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi , Delhi, India
| | - Sunny Goel
- Post Graduate Resident, Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi , Delhi, India
| | - Bharat Singh
- SAG Pathologist, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi , Delhi, India
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Mohanty D, Garg PK, Jain BK, Bhatt S. Unusual cause of shock: inferior vena cava obstruction complicating pyogenic liver abscess. J Surg Tech Case Rep 2014; 5:60-1. [PMID: 24470858 PMCID: PMC3889011 DOI: 10.4103/2006-8808.118635] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Debajyoti Mohanty
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi - 110 095, India
| | - Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi - 110 095, India
| | - Bhupendra Kumar Jain
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi - 110 095, India
| | - Shuchi Bhatt
- Department of Radiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi - 110 095, India. E-mail:
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Jain BK, Garg PK, Kumar A, Mishra K, Mohanty D, Agrawal V. Colonic perforation with peritonitis in amoebiasis: a tropical disease with high mortality. ACTA ACUST UNITED AC 2014; 34:83-6. [PMID: 24377154 DOI: 10.7869/tg.2012.102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Invasive colonic amoebiasis presents primarily with dysentery; colonic perforation occurs rarely. Cases of amoebic colonic perforations have been reported sporadically over the past 20 years. METHODS A retrospective study was done in the surgical unit of a tertiary care hospital in North India. The case records of those patients were reviewed who underwent exploratory laparotomy from January 2011 to September 2012 and were diagnosed with amoebic colonic perforation on histopathological examination. Details concerning the clinical presentation, investigations, intraoperative findings, operative procedures, and postoperative outcomes were retrieved. RESULTS Amongst, a total of 186 emergency exploratory laparotomies carried out during the study, 15 patients of amoebic colonic perforation were identified. The median age of the patients was 42 years (IQR 32.0-58.0) and the male to female ratio was 13:2. Previous history of colitis was present in only 1 patient. The preoperative diagnosis was perforation peritonitis in 12 patients; and intussusception, intestinal obstruction and ruptured liver abscess in 1 patient each. Ten patients had single perforation while 5 had multiple colonic perforations. All the patients except one had perforations in the right colon. Bowel resection was performed depending upon the site and extent of the colon involved-right hemicolectomy (8), limited ileocolic resection (6) and sigmoidectomy (1). Bowel continuity could be restored only in 2 of the 15 patients and a stoma was constructed in the remaining 13 patients. The overall mortality rate was found to be 40% (6/15). CONCLUSION Amoebic colonic perforation is associated with unusually high mortality.
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Affiliation(s)
- Bhupendra Kumar Jain
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, India.
| | - Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, India
| | - Anjay Kumar
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, India
| | - Kiran Mishra
- Department Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, India
| | - Debajyoti Mohanty
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, India
| | - Vivek Agrawal
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, India
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Mohta M, Ophrii EL, Sethi AK, Agarwal D, Jain BK. Continuous paravertebral infusion of ropivacaine with or without fentanyl for pain relief in unilateral multiple fractured ribs. Indian J Anaesth 2014; 57:555-61. [PMID: 24403614 PMCID: PMC3883389 DOI: 10.4103/0019-5049.123327] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 12/24/2022] Open
Abstract
Background: Continuous thoracic paravertebral block (TPVB) provides effective analgesia for unilateral multiple fractured ribs (MFR). However, prolonged infusion of local anaesthetic (LA) in high doses can predispose to risk of LA toxicity, which may be reduced by using safer drugs or drug combinations. This study was conducted to assess efficacy and safety of paravertebral infusion of ropivacaine and adrenaline with or without fentanyl to provide analgesia to patients with unilateral MFR. Methods: Thirty adults, having ≥3 unilateral MFR, with no significant trauma outside chest wall, were studied. All received bolus of 0.5% ropivacaine 0.3 ml/kg through paravertebral catheter, followed by either 0.1-0.2 ml/kg/hr infusion of ropivacaine 0.375% with adrenaline 5 μg/ml in group RA or ropivacaine 0.2% with adrenaline 5 μg/ml and fentanyl 2 μg/ml in group RAF. Rescue analgesia was provided by IV morphine. Results: Statistical analysis was performed using unpaired Student t-test, Chi-square test and repeated measures ANOVA. After TPVB, VAS scores, respiratory rate and PEFR improved in both groups with no significant inter-group differences. Duration of ropivacaine infusion, morphine requirements, length of ICU and hospital stay, incidence of pulmonary complications and opioid-related side-effects were similar in both groups. Ropivacaine requirement was higher in group RA than group RAF. No patient showed signs of LA toxicity. Conclusion: Continuous paravertebral infusion of ropivacaine 0.375% with adrenaline 5 μg/ml at 0.1-0.2 ml/kg/hr provided effective and safe analgesia to patients with unilateral MFR. Addition of fentanyl 2 μg/ml allowed reduction of ropivacaine concentration to 0.2% without decreasing efficacy or increasing opioid-related side-effects.
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Affiliation(s)
- Medha Mohta
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Emeni L Ophrii
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Ashok Kumar Sethi
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Deepti Agarwal
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - Bhupendra Kumar Jain
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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VS Murthy G, Jain BK, Shamanna BR, Subramanyam D. Improving cataract services in the Indian context. Community Eye Health 2014; 27:4-5. [PMID: 24966453 PMCID: PMC4069775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Gudlavalleti VS Murthy
- Director: Indian Institute of Public Health (Public Health Foundation of India), Hyderabad, India.
| | - BK Jain
- Trustee and Director: Shri Sadguru Seva Sangh Trust & Sadguru Netra Chikatsalaya, Chitrakoot, India
| | - BR Shamanna
- Associate Professor: School of Medical Sciences, University of Hyderabad, Hyderabad, India
| | - D Subramanyam
- Head: Community Ophthalmology Programmes, Sadguru Netra Chikatsalaya, Chitrakoot, India
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Garg PK, Verma R, Jain BK, Aggarwal S. Epiploic appendagitis: an uncommon cause of acute abdomen. Ann Afr Med 2013; 12:257-8. [PMID: 24309417 DOI: 10.4103/1596-3519.122699] [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: 11/04/2022] Open
Affiliation(s)
- Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
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Abstract
Back in the mid-1980s, a new branch of investigation related to the interaction of eta mesons with nuclei came into existence. It started with the theoretical prediction of possible exotic states of eta mesons and nuclei bound by the strong interaction and later developed into an extensive experimental program to search for such unstable states as well as understand the underlying interaction via eta-meson producing reactions. The vast literature of experimental as well as theoretical works that studied various aspects of eta-producing reactions such as the π(+)n → ηp, pd → (3)Heη, p (6)Li → (7)Be η and γ (3)He → η X, to name a few, had but one objective in mind: to understand the eta-nucleon (ηN) and hence the η-nucleus interaction which could explain the production data and confirm the existence of some η-mesic nuclei. In spite of these efforts, there remain uncertainties in the knowledge of the ηN and hence the η-nucleus interaction. Therefore, this review is an attempt to bind together the findings in these works and draw some global and specific conclusions which can be useful for future explorations.The ηN scattering length (which represents the strength of the η-nucleon interaction) using different theoretical models and analyzing the data on η production in pion, photon and proton induced reactions was found to be spread out in a wide range, namely, 0.18 ≤ Re aηN ≤ 1.03 fm and 0.16 ≤ Rm aηN ≤ 0.49 fm. Theoretical searches of heavy η-mesic nuclei based on η-nucleus optical potentials and lighter ones based on Faddeev type few-body approaches predict the existence of several quasibound and resonant states. Although some hints of η-mesic states such as (3)(η)He and (25)(η)Mg do exist from previous experiments, the promise of clearer signals for the existence of η-mesic nuclei lies in the experiments to be performed at the J-PARC, MAMI and COSY facilities in the near future. This review is aimed at giving an overall status of these efforts.
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Affiliation(s)
- N G Kelkar
- Dept. de Fisica, Univ. de los Andes, Cra 1E, 18A-10, Bogota, Colombia.
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Garg PK, Jain BK. Combined Use of Modified Alvarado Score and USG in Decreasing Negative Appendicectomy Rate: Critical Appraisal of Data. Indian J Surg 2013; 75:227. [DOI: 10.1007/s12262-013-0878-4] [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] [Received: 05/04/2010] [Accepted: 07/13/2010] [Indexed: 10/27/2022] Open
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Affiliation(s)
- P K Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, India
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Abstract
Jugular venous aneurysm is an extremely rare condition. The patients presented with a painless swelling in the neck that appears while coughing, straining, bending, or breath holding. Detection of a soft and compressible swelling in the course of an external jugular vein (EJV) superficial to the sternomastoid muscle, non-filling on compression of the EJV during Valsalva maneuver clinches the diagnosis of EJV aneurysm. Color Doppler ultrasound allows precise delineation of the lesion and is considered the gold standard for confirming the diagnosis. Surgical excision is indicated mostly for cosmetic reasons and symptomatic aneurysms. We, herein, report a patient with saccular external jugular venous aneurysm to highlight the typical clinical presentation and diagnosis of this rare entity.
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Affiliation(s)
- Debajyoti Mohanty
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
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Garg PK, Jain BK, Dubey IB, Sharma AK. Generalized lymphadenopathy: physical examination revisited. Ann Saudi Med 2013; 33:298-300. [PMID: 22750769 PMCID: PMC6078537 DOI: 10.5144/0256-4947.2012.01.7.1525] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We report an unusual case of prostatic carcinoma in a 47-year-old male that presented with generalized lymphadenopathy. He initially presented with metastatic lymphadenopathy. He underwent a battery of investigations to find the primary site of origin but to no avail. Thereafter, a complete and diligent physical examination revealed a hard and irregular normal-sized prostrate which was later confirmed as the primary site of tumor. This case report reiterates the significance of a precise and complete physical examination that may prove vital in avoiding superfluous expensive investigations and a delay in diagnosis.
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Affiliation(s)
- Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India.
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Abstract
Sixty-three patients presenting with subacute intestinal obstruction (SAIO) were studied. Thirty (47.6%) reported recurrent symptoms. Exaggerated bowel sound, visible/palpable bowel loops, distention of abdomen and abdominal lumps were observed in 60.3%, 28.5%, 25.3% and 19.0% patients, respectively. Thirty (47.6%) required emergency laparotomy. Investigations revealed lesions requiring surgery in 14 of 33 patients which were relieved with conservative treatment. The accuracy of ultrasonography, contrast enhanced computed tomography (CECT) scan and diagnostic laparoscopy was 57.1%, 100% and 100%, respectively. Ileum was the most common site of obstruction (79.5%). Adhesions and small intestinal strictures were the two most frequent cause of obstruction seen in 31.8% and 27.2%, respectively. Tuberculous pathology was demonstrated in 23 (52.2%). Previous abdominal surgery was found to be the only predictor of the success of conservative treatment (13/19 versus 7/44). All patients of SAIO, whose symptoms were relieved with conservative treatment, and who do not have history of abdominal surgery, should be subjected to CECT and/or diagnostic laparoscopy in order to discover the underlying cause of the obstruction. When these diagnostic modalities are not available, laparotomy is an effective alternative for this group of patients.
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Affiliation(s)
- Bhupendra Kumar Jain
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, India.
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Mohanty D, Choudhary D, Rathi V, Jain BK, Garg PK. Obturator internus abscess: spontaneous perforation into the vagina. Surg Infect (Larchmt) 2013; 14:167-8. [PMID: 23448591 DOI: 10.1089/sur.2011.134] [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: 11/13/2022] Open
Affiliation(s)
- Debajyoti Mohanty
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
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Affiliation(s)
- V Rathi
- University College of Medical Sciences and Guru Teg Bahadur Hospital Dilshad Garden, Delhi, India.
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Affiliation(s)
- P K Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India.
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Abstract
A 24-year-old lady presented with left flank pain of 3 months duration. She had stigmata of tuberous sclerosis complex in the form of angiofibromas on face, ash-leaf macules on back and right upper limb and shagreen patches over back. Computed tomography scan of the abdomen showed 6.5 cm × 5.0 cm × 4.4 cm lobulated intensely enhancing exophytic mass lesion in mid pole of left kidney with significant para-aortic lymphadenopathy with no evidence of fat in the mass. She underwent radical left nephrectomy with a provisional diagnosis of renal cell carcinoma. Histopathological examination showed multicenteric angiomyolipoma involving kidney and para-aortic lymph nodes. This case report underscores the need for further research to differentiate fat-poor angiomyolipoma and lymphadenopathy from renal cell carcinoma.
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Affiliation(s)
- Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
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Garg PK, Jain BK, Pandey SD, Rathi V, Puri AS. Simultaneous non-traumatic perforation of the right hepatic duct and gallbladder: an atypical occurrence. Malays J Med Sci 2012; 19:77-80. [PMID: 23610553 PMCID: PMC3629668] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 02/08/2012] [Indexed: 06/02/2023] Open
Abstract
Simultaneous non-traumatic perforation of the extrahepatic bile duct and the gallbladder is an uncommon occurrence that has been infrequently reported. We describe a patient with a spontaneous perforation of both the extrahepatic bile duct and the gallbladder. A contrast-enhanced computed tomography (CECT) scan of the abdomen and endoscopic retrograde cholangiopancreatography (ERCP) demonstrated a perforation of the gallbladder and a free leak from the right hepatic duct, respectively. Endoscopic biliary drainage following a sphincterotomy and biliary stent placement led to a dramatic improvement in the patient's general condition. He was subsequently scheduled to undergo an elective cholecystectomy. Repeat ERCP performed at 4 weeks after the initial stenting showed a normal cholangiogram and a distally migrated stent, which was there after removed. However, early stent removal led to re-perforation of hepatic duct and gallbladder. A repeat endoscopic biliary drainage did not help, and the patient developed biliary peritonitis. Surgical exploration revealed a perforation at the fundus of the gallbladder, 400 ml of biliopurulent collection and a frozen Calot's triangle. A subtotal cholecystectomy, gall stone removal, and a thorough peritoneal lavage were undertaken. The patient improved postoperatively. The second biliary stent was removed after 4 months. This case report highlights the role of endoscopic biliary drainage in the management of an extrahepatic bile duct perforation and warns against the early removal of a biliary stent.
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Affiliation(s)
- Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi 110095, India
| | - Bhupendra Kumar Jain
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi 110095, India
| | - Satya Deo Pandey
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi 110095, India
| | - Vinita Rathi
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi 110095, India
| | - Amarendra Singh Puri
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi 110095, India
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Garg PK, Singh AP, Jain BK, Bansal A, Mohanty D, Agrawal V. Safety and Acceptance of Non-Sedated Upper Gastrointestinal Endoscopy: A Prospective Observational Study. J Laparoendosc Adv Surg Tech A 2012; 22:315-8. [DOI: 10.1089/lap.2011.0463] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
| | - Abhishek Pratap Singh
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
| | - Bhupendra Kumar Jain
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
| | - Amit Bansal
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
| | - Debajyoti Mohanty
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
| | - Vivek Agrawal
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
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Affiliation(s)
- Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, 110095, India.
| | - Bhupendra Kumar Jain
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, 110095, India
| | - Debajyoti Mohanty
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, 110095, India
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Jain BK, Vaibhaw K, Garg PK, Gupta S, Mohanty D. Comparison of a fistulectomy and a fistulotomy with marsupialization in the management of a simple anal fistula: a randomized, controlled pilot trial. J Korean Soc Coloproctol 2012; 28:78-82. [PMID: 22606646 PMCID: PMC3349814 DOI: 10.3393/jksc.2012.28.2.78] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Revised: 10/25/2011] [Accepted: 11/09/2011] [Indexed: 11/17/2022]
Abstract
Purpose This randomized clinical trial was conducted to compare a fistulectomy and a fistulotomy with marsupialization in the management of a simple anal fistula. Methods Forty patients with simple anal fistula were randomized into two groups. Fistulous tracts were managed by using a fistulectomy (group A) while a fistulotomy with marsupialization was performed in group B. The primary outcome measure was wound healing time while secondary outcome measures were operating time, postoperative wound size, postoperative pain, wound infection, anal incontinence, recurrence and patient satisfaction. Results Postoperative wounds in group B healed earlier in comparison to group A wounds (4.85 ± 1.39 weeks vs. 6.75 ± 1.83 weeks, P = 0.035). No significant differences existed between the operating times (28.00 ± 6.35 minutes vs. 28.20 ± 6.57 minutes, P = 0.925) and visual analogue scale scores for postoperative pain on the first postoperative day (4.05 ± 1.47 vs. 4.50 ± 1.32, P = 0.221) for the two groups. Postoperative wounds were larger in group A than in group B (2.07 ± 0.1.90 cm2 vs. 1.23 ± 0.87 cm2), however this difference did not reach statistical significance (P = 0.192). Wound discharge was observed for a significantly longer duration in group A than in group B (4.10 ± 1.91 weeks vs. 2.75 ± 1.71 weeks, P = 0.035). There were no differences in social and sexual activities after surgery between the patients of the two groups. No patient developed anal incontinence or recurrence during the follow-up period of twelve weeks. Conclusion In comparison to a fistulectomy, a fistulotomy with marsupialization results in faster healing and a shorter duration of wound discharge without increasing the operating time.
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Affiliation(s)
- Bhupendra Kumar Jain
- Department of Surgery, Guru Teg Bahadur Hospital, University of Delhi College of Medical Sciences, Delhi, India
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Affiliation(s)
- Bhupendra Kumar Jain
- Department of Surgery University College of Medical Sciences and Guru Teg Bahadur Hospital University of Delhi Delhi, India
| | - Dharmendra Prasad
- Department of Surgery University College of Medical Sciences and Guru Teg Bahadur Hospital University of Delhi Delhi, India
| | - Debajyoti Mohanty
- Department of Surgery University College of Medical Sciences and Guru Teg Bahadur Hospital University of Delhi Delhi, India
| | - Pankaj Kumar Garg
- Department of Surgery University College of Medical Sciences and Guru Teg Bahadur Hospital University of Delhi Delhi, India
| | - Preti Diwaker
- Department of Pathology University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
| | - Vivek Agarwal
- Department of Surgery University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
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Jain BK, Prasad D, Mohanty D, Garg PK, Diwaker P, Agarwal V. Gallbladder perforation: a great masquerader. Am Surg 2012; 78:E30-E32. [PMID: 22273300] [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: 05/31/2023]
Affiliation(s)
- Bhupendra Kumar Jain
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India.
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Garg PK, Jain BK, Rathi V, Singh N, Mohanty D. Mid-arm and epitrochlear lymphadenopathy: a clinico-radiological surprise. J Infect Dev Ctries 2011; 5:820-4. [PMID: 22112738 DOI: 10.3855/jidc.1657] [Citation(s) in RCA: 4] [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] [Received: 10/15/2010] [Revised: 02/11/2011] [Accepted: 02/11/2011] [Indexed: 10/31/2022] Open
Abstract
An 18-year-old man presented with multiple subcutaneous nodules over the anteromedial aspect of his right lower arm. Based on findings of sonography, histopathology, circulating filarial antigen test, and therapeutic response to diethylcarbazine, a diagnosis of filarial lymphadenopathy affecting mid-arm nodes and epitrochlear lymph nodes was made.
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Affiliation(s)
- Pankaj Kumar Garg
- Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India.
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Sudhan A, Khandekar R, Deveragonda S, Devi S, Jain BK, Sachan R, Singh V. Patient satisfaction regarding eye care services at tertiary hospital of central India. Oman J Ophthalmol 2011; 4:73-6. [PMID: 21897622 PMCID: PMC3160073 DOI: 10.4103/0974-620x.83657] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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: 11/04/2022] Open
Abstract
PURPOSE To evaluate patients' satisfaction regarding eye care services and suggest policy changes accordingly. STUDY DESIGN Descriptive study. MATERIALS AND METHODS This study was conducted between September 2005 and June 2006. Patients attending the eye clinic of Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India, and admitted as in-patients in this hospital were our study population. Randomly selected patients were interviewed by trained staff. Close-ended questionnaire was used to conduct these structured interviews. Their responses were grouped into one of five categories and evaluated to determine satisfaction for different components of eye care services. RESULTS Three hundred and twenty persons were interviewed. The satisfaction was of excellent grade among 77 (48.1%) patients attending clinic and 156 (97.5%) patients who were admitted in the hospital. The participants expressed dissatisfaction for the long waiting period in clinics, poor cleanliness, and insufficient toilet facilities. Those admitted in the hospital felt that food facilities were less than the expected quality. Child-friendly facilities received high satisfaction scores. CONCLUSION Although eye care services both in clinics and in the wards were satisfactory according to the end-users, there are scopes for improvement. Patient satisfaction surveys should be encouraged in hospitals for better accountability and also for strengthening the quality of eye care services.
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Affiliation(s)
- Anand Sudhan
- Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
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