Surgical patterns in osteoporotic vertebral compression fractures.

Purpose: To report morphological patterns of osteoporotic vertebral compression fractures (OVCFs) presenting for surgery. To describe surgical options based on fracture pattern. To evaluate clinical and radiological outcome.

Autoimmune hemolysis in malaria: a report of three cases.

We have recently treated three patients with malaria who developed post malaria immune mediated hemolysis. These cases, seen with in a span of three month period (September 09 to November 09) form the basis of this report. Out of three patients, two were treated with steroids and both responded favorably.

Monoclonal gammopathies presenting as inflammatory arthritis: uncommon but important--a case series.

Objective: To review the clinical profile of patients with plasma cell dyscrasias presenting with inflammatory arthritis.

Material And Methods: Retrospective analysis was performed on clinical, laboratory and imaging data of patients who presented with inflammatory arthritis between May 2009 and April 2010 and were subsequently diagnosed as having plasma cell dyscrasias. Six out of 630 patients presenting with inflammatory arthritis were identified.

Standardization of fungal polymerase chain reaction for the early diagnosis of invasive fungal infection.

Background: An early initiation of antifungal therapy in invasive fungal infections (IFIs) is critical in reducing the high mortality rate. Current diagnosis of fungal infection relies on microscopy, culture, antigen, antibody specific tests and histological diagnosis. However, these tests either lack sensitivity or specificity.

Bisphosphonate-induced osteonecrosis of the jaw.

Bisphosphonates are routinely used in the prevention and treatment of osteoporosis. Osteonecrosis of the jaw is known to be an important but rare complication of bisphosphonate usage. We present our experience with two patients of osteonecrosis of the jaw due to bisphosphonate usage.

The relevance of ESBL producing isolates in patients surgically treated for acute appendicitis.

Background: In India, there is a high prevalence of ESBL producing organisms among intraabdominal isolates and in stool flora of 'normal' individuals. Hence, it may be presumed that unless antimicrobial therapy effective for ESBL flora is used perioperatively for abdominal surgery, the outcome will be adverse. We selected patients surgically treated for appendicitis as a model to explore the relevance of ESBL producing isolates in this retrospective observational study.

Lutetium DOTATATE whole body scans: A novel approach for evaluation of neuroendocrine tumors.

Aim: We undertook a study to evaluate whether Lutetium (Lu) DOTATATE whole body scan is well comparable to Gallium positron emission tomography (PET) / Indium Octreotide, and hence with dosimetric advantage can replace it in the pre-therapy setting.

Materials And Methods: We undertook a prospective study of a total of 39 patients with metastatic neuroendocrine tumor (age 11-70 years), who underwent Lu-DOTATATE scans within the period August 2009-November 2010. This included 28 males and 11 females.

Rapid diagnosis of extensively drug-resistant tuberculosis by use of a reverse line blot hybridization assay.

Drug resistance in tuberculosis (TB) is a matter of grave concern for TB control programs, as there is currently no cure for some extensively drug-resistant (XDR) strains. There is concern that this resistance could transmit, stressing the need for additional control measures, rapid diagnostic methods, and newer drugs for treatment. We developed an in-house assay that can rapidly detect resistance to drugs involved in the definition of XDR-TB directly from smear-positive specimens.

Xpert MTB/RIF: a new pillar in diagnosis of extrapulmonary tuberculosis?

Approximately 10 to 15% of tuberculosis (TB) cases in India are estimated to have extrapulmonary disease, and due to a lack of diagnostic means, they often remain untreated. The early detection of Mycobacterium tuberculosis and multidrug resistance is a priority in TB diagnosis to improve the successful treatment rate of TB and reduce transmission. The Xpert MTB/RIF (Xpert) test, recently endorsed by the World Health Organization for the detection of pulmonary TB, was evaluated to test its utility in 547 patients with suspected extrapulmonary tuberculosis.

Application of magnetic resonance tractography in the perioperative planning of patients with eloquent region intra-axial brain lesions.

We aimed to assess the role of preoperative diffusion tensor tractography (DTT) in the surgical planning and prognostication of the postoperative outcome of patients with lesions in the eloquent areas of the brain. From 2006 to 2009, 50 patients were preoperatively evaluated with DTT and image-guidance studies. Three-dimensional (3D) color trajectory maps of white-matter tracts adjacent to the lesions were reconstructed.

Giant cell arteritis in Mumbai.

Objective: To study the clinical profile of patients with giant cell arteritis in Mumbai.

Methods: From our database, patients with a diagnosis of giant cell arteritis (GCA) over a fifteen year period (January 1990 to December 2005) were included. Clinical manifestations, temporal artery biopsy, treatment, and follow-up data of these patients were analyzed.

Infective endocarditis--a tale of two cases and the lessons (re)learned.

Infective endocarditis due to uncommon organisms or at uncommon sites presents a diagnostic challenge. Because signs and symptoms can be nonspecific and vary greatly, a high index of suspicion is necessary. We have recently treated two such cases, one due to HACEK organism (Eikenella corrodens) in a patient with established valvular heart disease and other of right sided endocarditis due to Pseudomonas aeruginosa.

Revision of broken knee megaprostheses: new solution to old problems.

Background: Low-cost indigenous megaprostheses used in the developing world are prone to mechanical failure but the frequency and causes are not well established.

Questions/purposes: We retrospectively analyzed the causes of failure, particularly design, and suggest changes to reduce the breakage. We also report our experience with revision surgery.

Evaluation of the bactec MGIT 960 TB system for recovery and identification of Mycobacterium tuberculosis complex in a high through put tertiary care centre.

Aim: To evaluate the performance of an automated BACTEC MGIT 960, a non-radioactive, non-invasive liquid culture system for cultivation of M. tuberculosis complex in terms of recovery rate and time.

Materials And Methods: From March 2005 to December 2007, 14,597 specimens were processed using the MGIT 960 system and the results were compared with conventional L.

Acute enteritis associated with pneumococcal bacteremia.

We describe an elderly male who had a two day history of fever, abdominal pain and watery loose motions. Clinical examination was positive for abdominal right lower quadrant tenderness and moderate dehydration. Stool examination revealed inflammatory diarrhea.

Gamma knife radiosurgery in jugular foramen endolymphatic sac adenocarcinoma.

A 41-year-old male presented to us with a history of right-sided temporal headache and ear discharge. MRI revealed an extra-axial space-occupying lesion in the region of the right jugular foramen. The patient was operated upon and a radical excision of the tumor was performed.

Neonatal hypoglycemic brain - injury a common cause of infantile onset remote symptomatic epilepsy.

Objectives: To study the etiology of remote symptomatic epilepsy with onset in the first 3 years of life. Patients with neonatal hypoglycemic brain injury (NHBI), were further studied for risk factors and clinical features.

Methods: The study was conducted at a tertiary pediatric neurology service between May-August 2004.

Staple versus locking compression plate fixation after lateral closing wedge high tibial osteotomy.

Purpose: To compare the results of staple versus locking compression plate fixation after closing wedge high tibial osteotomy.

Methods: A group of 23 patients (24 knees) who underwent box high tibial osteotomy and staple fixation was compared with another group of 19 patients (22 knees) who underwent a similar procedure but with locking compression plate fixation. Both groups were followed up for 3 years.