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1.
Aravind Kumar Naresh Kumar Anirudh Gadgil 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2006,16(1):80-82
We present a case of wooden foreign bodies in the foot with delayed diagnosis. Unreliability of plain radiographs in these situations is emphasized. The comparative utility of computed tomography, magnetic resonance scans and ultrasonography is evaluated from a literature review. We utilized a sinogram which showed the splinters and also indicated their location and orientation in a region of complex anatomy, thus reducing surgical time and morbidity. Management of a suspected radiolucent foreign body is fraught with pitfalls and we provide a possible algorithm for management. 相似文献
2.
Liana Beni-Adani Naresh Biani Liat Ben-Sirah Shlomi Constantini 《Child's nervous system》2006,22(12):1543-1563
Background and objective The classification of hydrocephalus in newborns and in infants is different from the classification in adulthood. This difference
exists due to disparity in the source pathologies that produce the hydrocephalus, and the practical distinctions in prognosis
and treatment choices. The objective of this paper is to present the spectrum of obstructive-communicating hydrocephalus,
which is more complex in the pediatric group, and to propose the relevance of this particular classification to treatment
options.
Materials and methods The authors categorized infants with active hydrocephalus at time of presentation into the following four groups along the
spectrum of communicating vs obstructive HCP. Group 1: patients with a purely absorptive (communicating) HCP. In these patients,
tetraventricular dilatation is usually observed with occasional extraaxial fluid accumulation. An extracranial CSF diversion
(shunt) is the treatment of choice. Group 2: patients with an obstructive component together with a persistent absorptive
component. In these patients, a technically successful endoscopic procedure will not prevent progression of clinical symptoms
of HCP. An extracranial CSF diversion (shunt) should be the treatment of choice even though some of these patients are currently
treated by endoscopy. Group 3: patients with an obstructive component together with a temporary absorptive component. In these
patients, a technically successful ETV should be followed by temporary CSF drainage [via LP, continuous spinal drainage (CLD),
or ventriculostomy] with or without supplemental medical treatment (i.e., Diamox) for several days. Such temporary drainage
may decrease failure rate in this subgroup. Group 4: patients with a purely obstructive HCP. In these patients, an endoscopic
procedure (ETV) is the treatment of choice. According to this spectrum classification, the authors classify different entities
with representative cases and discuss relevancy to treatment options and prognosis.
Results The data suggest that obstructive hydrocephalus in the very young population may be rather a combination of obstructive and
absorptive problem. The outcome of the patient depends mainly not only on the basic pathology causing the hydrocephalus but
also on the treatment that is chosen and its complications. While bleeding and infection represent the major causes for communicating
hydrocephalus, patients with complex pathologies of congenital type and intra- or interventricular obstructions may reflect
obstructive hydrocephalus. Treatment of these patients may be successful by shuntless procedures if the absorptive problem
is not the major component. In transient absorptive hydrocephalus, temporary measures were effective in many cases leading
to successful procedures of ETV and/or posterior-fossa decompression in selected cases.
Conclusions Shuntless procedures are the dream of a pediatric neurosurgeon provided it solves the problem and does not imply unacceptable
risk. However, the benefit has to be evaluated years after the procedure is performed, as only prospective multicenter studies
will truly show which procedure may have the best overall results in the developing child. Until such studies are available,
understanding the basic pathology or the combination of pathologies leading to hydrocephalus in a given child may open the
window of opportunities for other than shunt surgery in many hydrocephalic children with major obstructive component. 相似文献
3.
Naresh Agarwal Rajnish Monga A S Puri 《Indian journal of gastroenterology》2003,22(6):238; author reply 238-238; author reply 239
4.
BACKGROUND: Daytime sleepiness is common in patients with sleep-disordered breathing. Although respiratory events during sleep are associated with the occurrence of daytime sleepiness, the differential impact of these events during non-rapid eye movement (NREM) and rapid eye movement (REM) sleep on daytime sleepiness has not been well characterized. STUDY OBJECTIVES: To determine the effect of respiratory events during REM sleep and NREM sleep on daytime sleepiness, as assessed by the multiple sleep latency test (MSLT). DESIGN: Cross-sectional study. SETTING: University-based sleep disorders laboratory. PARTICIPANTS: Patients referred for polysomnography and daytime MSLT (n=1,821). INTERVENTIONS: N/A MEASUREMENTS AND RESULTS: The study sample was initially divided into quartiles based on the level of the apnea-hypopnea index (AHI) during NREM sleep. Within the first NREM-AHI quartile (NREM-AHI < 8.3 events/hr), the association between REM-related respiratory events and daytime sleepiness was examined using the method of Kaplan-Meier analysis and Cox proportional hazards regression. After adjusting for age, gender, body mass index, and the duration of NREM and REM sleep, REM-AHI was not associated with daytime sleepiness (Relative Risk: 1.01; 95%CI: 0.94-1.10). Similarly, no significant association was observed between REM-AHI and the MSLT in patients within the second through fourth NREM-AHI quartiles. In contrast, increasing severity of disordered breathing during NREM sleep was associated with daytime sleepiness. For a 10-point increase in NREM-AHI, the adjusted relative risks for daytime sleepiness in the second through fourth NREM-AHI quartile were 1.21 (95%CI: 1.01-1.46), 1.20 (95%CI: 1.05-1.37), and 1.10 (95%CI: 1.04-1.16), respectively. CONCLUSION: Sleep-disordered breathing during NREM sleep, but not REM sleep, is associated with increased risk of daytime sleepiness. 相似文献
5.
Arunaloke Chakrabarti Ashim Das Jharna Mandal M R Shivaprakash Varghese K George Bansidhar Tarai Pooja Rao Naresh Panda Subhash C Verma Vinay Sakhuja 《Medical mycology》2006,44(4):335-342
Zygomycosis is an emerging infection worldwide. A study was conducted to understand its spectrum in the Indian scenario. All patients diagnosed for invasive zygomycosis at a tertiary care center in north India from 2000-2004, were retrospectively analyzed. A total of 178 cases (mean average of 35.6 cases/year) of zygomycosis were diagnosed. Rhino-orbito-cerebral type (54.5%) was the commonest presentation followed by cutaneous (14.6%), disseminated (9.0%), and gastrointestinal (8.4%) zygomycosis. Renal and pulmonary zygomycosis were seen in 6.7% patients each. Uncontrolled diabetes mellitus (in 73.6% of cases) was the significant risk factor in all types (Odds Ratio 1.5-8.0) except renal zygomycosis. Breach of skin was the risk factor in 46.2% patients with cutaneous zygomycosis. However, no risk factor could be detected in 11.8% patients. Antemortem diagnosis was possible in 83.7% cases. The commonest (61.5%) isolate was Rhizopus oryzae followed by Apophysomyces elegans in 27% patients. Combination of debridement surgery and amphotericin B therapy was significantly better in survival of the patients (P<0.005) than amphotericin B alone (79.6% vs. 51.7% survival). Thus, a rising trend of invasive zygomycosis was observed in patients with uncontrolled diabetes mellitus in India. Consistent diagnosis of renal zygomycosis in apparently healthy hosts and the emergence of A. elegans in India demand further study. 相似文献
6.
Arvind Kumar Naresh Jindal Chhote L Shukla Rajesh K Asrani David R Ledoux George E Rottinghaus 《Avian pathology》2004,33(4):413-417
A study was conducted to evaluate the effects of ochratoxin A (OA) on Escherichia coli-challenged broiler chickens. One hundred and eighty-four one-day-old broiler chicks were divided into two groups of 92 chicks each, with one group fed a control mash diet and the other fed a mash diet containing 2 parts/10(6) OA. On day 14, each group was further subdivided into two groups with one group inoculated with E. coli O78 (1 x 10(7) colony-forming units/0.5 ml) by the intraperitoneal route, whereas the other group was not inoculated with E. coli. Four birds from each group were sacrificed at 1, 2, 3, 5, 7, 10, 14 and 21 days post-inoculation to record pathological changes in the liver, kidneys, heart, lungs, bursa, spleen and thymus. E. coli infection induced perihepatitis and pericarditis in the liver and heart, respectively, in chickens infected with E. coli alone or in OA-fed birds from 1 day post-infection (DPI) onwards. At 1 DPI, a thin fibrin layer covered the liver and heart; however, at subsequent days, the layer became thicker. E. coli infection did not produce appreciable changes in the kidneys, bursa or thymus. However, there was congestion of the lungs along with mononuclear cell infiltration. Ochratoxin feeding induced changes from 10 DPI onwards in chicks fed OA alone and those infected with E. coli. The changes in kidneys included swollen proximal convoluted tubules, degeneration of tubular epithelium and interstitial nephritis. Degenerative changes and mononuclear cell infiltration were recorded in the liver. There was atrophy of the lymphoid organs along with depletion of lymphocytes. Gross and histopathological changes were more severe in chickens fed OA and inoculated with E. coli than the chickens fed OA alone or those infected with E. coli, indicating combined action of these two. 相似文献
7.
Naresh K. Panda S. B. S. Mann Satish Mehta 《Indian journal of otolaryngology and head and neck surgery》1994,46(4):210-212
Retropharyngeal cystic hygroma is a rare condition and needs to be differentiated from common clinical condition of retropharyngeal abscess. Two such cases are discussed in the present report. 相似文献
8.
S. C. Mishra Harsh Sharma A. Saxena Naresh Bhatia G. K. Shukla 《Indian journal of otolaryngology and head and neck surgery》1994,46(3):124-127
Episodic Vertigo Comprises a large group of patients seen in any neurootology unit. A total of 118 subjects were reviewed who attended the neurootology unit. Vertigo of shorter duration was noted in 78 and of longer duration in 40 cases. 51 cases showed bilateral neurosensory deafness, 15 cases had bilateral and another one case had unilateral conductive loss. Spinovestibular tests were abnormal in all cases of vertigo of short duration but only 29 cases showed abnormal reflex in patients with a long duration of illness. Thermal vestibulometry revealed hyporeflexia in 33 cases, directional preponderance in 30 cases and 4 cases showed hyperreflexia 28 cases had peripheral lesions while 81 cases had central lesions. The acute cases showed significant improvement on follow up except cases with abnormality in thermal vestibulometry . The cases with positional nystagmus showed improvement with head and body balance exercises expect in those who received treatment with vestibulosedative and vestibular suppersive drugs. Hearing loss remained the same except in patients with middle ear disorders. 相似文献
9.
Immunohistological localisation of vascular endothelial growth factor in human endometrium. 总被引:2,自引:0,他引:2
B Naresh J Sengupta V Bhargava G Kinra J Hu D Ghosh 《Indian journal of physiology and pharmacology》1999,43(2):165-170
Several polypeptide growth factors regulate epithelial and stromal development in endometrium under the influence of estrogen and progesterone, and thereby regulate growth and differentiation of endometrium during menstrual cycle. However, little is known about the angiogenic growth factors that may affect endometrial vasculature throughout each menstrual cycle. Vascular endothelial growth factor (VEGF) is suggestively an important angiogenic growth factor in the female reproductive tract. The aim of the present study was to immunolocalize and assess semi-quantitatively VEGF immunostaining in cells of proliferative phase (n = 3), secretory phase (n = 6) and hyperplastic (n = 6) human endometrial samples. VEGF concentrations were significantly higher in glandular (P < 0.001) and stromal (P < 0.01) compartments of proliferative stage endometrium compared with those in secretory stage and hyperplastic endometrial samples, with no difference in the scores for glandular and stromal compartments between secretory stage and hyperplastic endometrial samples. Generally, glandular expression of VEGF was higher as compared to stromal compartment. Thus, it appears that endometrial VEGF expression and concentration are enhanced by estrogen, and may be correlated with neovascularization and increased vascular permeability during late proliferative period. Additionally, there was no enhancement in VEGF expression in hyperplastic glands, suggesting that regulation of glandular growth and that of angiogenesis in human endometrium operate through different mechanisms. 相似文献
10.
Nadkarni JJ Perambakam SM Rathore VB Amin KM Parikh PM Naresh KN Advani SH 《Cancer biotherapy & radiopharmaceuticals》1998,13(4):269-274
The trafficking or homing of different lymphoid subsets to particular microenvironment is mediated by specific cell adhesion molecules (CAMs) expressed on lymphocytes and endothelial cells. B-cell chronic lymphocytic leukaemia (B-CLL) or Non-Hodgkin's lymphoma of small lymphocytic, B-cell type are monoclonal expansions of mature lymphocytes. The relative distribution of the tumor lymphocytes among various lymphoid compartments vary from patient to patient. Very few studies underlying this issue are available. To this effect, we have analysed the expression of LFA-1; VLA-4, ICAM-1; CD44H and CD44v6 (haematopoietic and variant form respectively) on freshly isolated lymphocytes obtained from bone marrow (BM), peripheral blood (PB) and lymph node (LN) by flow cytometry. Overall, we find strong expression of CD44H, low to moderate expression of LFA-1, negative to low expression of VLA-4 and lack of expression of CD44v6. ICAM-1 expression was observed only in patients with prominent lymphadenopathy. Higher expression of CD44H in PB lymphoid cells relative to that of BM lymphoid cells correlated with higher PB lymphocytosis (p < 0.001). Proliferating cell nuclear antigen expression in LN sections correlated inversely with VLA-4 expression on BM and PB lymphoid cells (p < 0.05). There was no significant correlation between expression of CAMs and bcl-2 protein. 相似文献