1
|
Sharma P, Singh T, Mishra D, Gaiha M. Parvovirus B-19 induced acute pure red cell aplasia in patients with chronic lymphocytic leukemia and neurofibromatosis type-1. Hematology 2013; 11:257-9. [PMID: 17178664 DOI: 10.1080/10245330600954171] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Parvovirus B19 induced pure red cell aplasia (PRCA) has been previously reported in a variety of settings. We present two cases, an adult patient with chronic lymphocytic leukemia (CLL) and a child with neurofibromatosis type-1 (NF-1), where the abrupt appearance of severe anemia raised ominous clinical suspicions. Evidence of recent parvovirus B19 infection in association with the selective erythroid precursor deficiency in marrow helped exclude other etiologies. We emphasize the importance of bearing this infectious agent in mind, even when there are associated disorders (such as CLL) that may independently cause PRCA. An association of NF-1 with acute PRCA has not been described in indexed English literature in the past.
Collapse
Affiliation(s)
- Prashant Sharma
- Department of Pathology, Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi, 110002, India.
| | | | | | | |
Collapse
|
2
|
Bhise A, Krishnan PV, Aggarwal R, Gaiha M, Bhattacharjee J. Effect of low-dose omega-3 fatty acids substitution on blood pressure, hyperinsulinemia and dyslipidemia in Indians with essential hypertension: A pilot study. Indian J Clin Biochem 2012; 20:4-9. [PMID: 23105526 DOI: 10.1007/bf02867393] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The present study comprised 100 patients of essential hypertension who were screened for fasting hyperinsulinemia, which was detected in 77% cases. Twenty such hyperinsulinemic cases were subjected to 4 weeks of dietary control phase followed by 6 weeks of omega-3 fatty acids substitution [either 0.6 g/d (group 1) or 1.2 g/d (group 2)]. The mean basal fasting plasma insulin levels were significantly higher (p<0.001) in patients of hypertension when compared to normal controls (126.51±80.36 and 19.35±12.61 μU/ml respectively). At the end of 4 weeks of diet control only, no significant change was observed in any parameter. After substitution of omega-3 fatty acid, a significant reduction of fasting plasma insulin levels in both group 1 (29%) and group 2 (22.8%) was observed (p<0.001). Significant reduction of systolic and diastolic blood pressure (16.4% and 25% respectively), serum cholesterol, triglycerides and low density lipoprotein was also noted in both groups (p<0.001), while high density lipoprotein increased by ∼8 mg% in both groups. Thus omega-3 fatty acid substituion in low dose along-with curtailment of dietary omega-6 fatty acid may be used as an adjunctive measure in the management of essential hypertension.
Collapse
Affiliation(s)
- A Bhise
- Department of Medicine, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi
| | | | | | | | | |
Collapse
|
3
|
Sharma P, Setia N, Nigam S, Jain S, Gaiha M, Singh T. Richter syndrome in CLL - an aspiration cytologic diagnosis. Indian J Hematol Blood Transfus 2008; 24:39. [PMID: 23100941 DOI: 10.1007/s12288-008-0023-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: 12/30/2007] [Accepted: 02/22/2008] [Indexed: 11/30/2022] Open
Affiliation(s)
- Prashant Sharma
- Department of Pathology, Maulana Azad Medical College and Lok Nayak Hospital, BSZ Marg, New Delhi, 110 002 India
| | | | | | | | | | | |
Collapse
|
4
|
Singh NP, Jhamb R, Agarwal SK, Gaiha M, Dewan R, Daga MK, Chakravarti A, Kumar S. The 2003 outbreak of Dengue fever in Delhi, India. Southeast Asian J Trop Med Public Health 2005; 36:1174-8. [PMID: 16438142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Dengue fever (DF) and Dengue hemorrhagic fever (DHF) are widespread in Southeast Asia. An outbreak of DF/DHF in Delhi in 2003 started during September, reached its peak in October-November, and lasted until early December. This study describes the clinical and laboratory data of the 185 cases of DF/DHF admitted to Lok Nayak Hospital, New Delhi. The mean age of the patients was 26 +/- 10 years. Fever was present in all the cases with an average duration of fever being 4.5 +/- 1.2 days with headache (61.6%), backache, (57.8%), vomiting (50.8%) and abdominal pain (21%) being the other presenting complaints. Hemorrhagic manifestations in the form of a positive tourniquet test (21%), gum bleeding and epistaxis (40%), hematemesis (22%), skin rashes (20%) and melena (14%) were also observed. Hepatomegaly and splenomegaly were observed in 10% and 5% of cases, respectively. Laboratory investigations revealed thrombocytopenia (with a platelet count of < 100,000/microl) in about 61.39% of cases, Leukopenia (WBC <3,000/mm2) and hemoconcentration (Hct >20% of expected for age and sex) were found in 68% and 52% of the cases, respectively. The mortality rate was 2.7%. Despite widespread measures taken to control outbreaks of DF, it caused major outbreaks. More stringent measures in the form of vector control, improved sanitation and health education are needed to decrease morbidity, mortality and health care costs caused by a preventable disease.
Collapse
Affiliation(s)
- N P Singh
- Departments of Medicine and Microbiology, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | | | | | | | | | | | | | | |
Collapse
|
5
|
Singh S, Gupta R, Singh T, Gaiha M. Non-secretory plasma cell leukemia: a rare hematological malignancy. INDIAN J PATHOL MICR 2004; 47:592-3. [PMID: 16295407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
|
6
|
Singhal N, Singh T, Singh ZN, Shome DK, Gaiha M. Histomorphology of multiple myeloma on bone marrow biopsy. INDIAN J PATHOL MICR 2004; 47:359-63. [PMID: 16295424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Abstract
In a retrospective study, 49 bone marrow biopsies (BMB) of patients with multiple myeloma (MM) were studied for its role in diagnosis and to determine histological parameters of prognostic significance. Sections were analyzed by 2 observers and classified according to: 1. Cytological grading according to differentiation of the neoplastic cells as plasmacytic, pleomorphic and plasmablastic. 2. Volume of infiltration: quantitating the percentage of myeloma cells in the biopsy. 3. Pattern of neoplastic infiltration. The overall marrow cellularity, presence of marrow fibrosis, micro-osteolesions and normal haematopoeisis were also studied. The bone marrow biopsy (BMB) was diagnostic for myeloma in five cases, where the aspirates were hypocellular: four had early myeloma and one had extensive marrow fibrosis. The pattern of infiltration was interstitial in 19 cases (39%), nodular in 19 cases (39%), and diffuse in 11 cases (22%). In majority of the cases (49%), the cell type was plasmacytic (24 cases), plasmablastic in 10 cases and pleomorphic in 15 cases. All cases of poorly differentiated cell type (plasmablastic) had a diffuse or nodular pattern of infiltration, whereas majority of the well-differentiated cell type had an interstitial pattern. The plasma cell burden in biopsy i.e the volume of infiltration was <10% in 8 cases, <50% in 19 cases and >50% in 22 cases and was used for histological staging of MM. Fibrosis was present in 30% of cases. Follow up was available in 11 cases, and cases with poorly differentiated myeloma, diffuse pattern of infiltration and dense fibrosis had survival less than one year. Cases of well differentiated myeloma, interstitial pattern of infiltration and plasma cell load less than 20% with absence of fibrosis had a more than 5-year survival. Different series have quoted that all these histological parameters provide valuable prognostic information, wherever other modalities like beta 2 microglobulin and IL-6 levels, etc are not available. The effects of therapy can also be monitored by sequential biopsies.
Collapse
Affiliation(s)
- Niti Singhal
- Departments of Pathology and Medicine, Maulana Azad Medical College, Bahadur Shah Zafar Marg, New Delhi.
| | | | | | | | | |
Collapse
|
7
|
Abstract
An evaluation was made of the diagnostic efficacy and utility of the Parasight-F test in diagnosing Plasmodium falciparum malaria, compared with conventional microscopy, particularly in severe and complicated cases. This study was designed as a prospective, case control hospital-based study. Febrile patients suspected to be suffering from malaria were selected randomly and were subjected to peripheral smear examinations (thick and thin) and Parasight-F tests till the required number of at least 30 cases of P. falciparum infection were identified, including at least 15 complicated cases. In addition 20 cases of P. vivax malarial infection as well as 20 healthy age and sex-matched individuals were taken as two control groups. The outcome measure was the number of cases with positive Parasight-F test results compared with conventional microscopy. Thirty-two patients with P. falciparum malaria were identified, with 15 severe and complicated cases. Peripheral smears were positive in 29 (91%) of these, while parasight-F test was positive in 31 out of 32 (97%) cases. Parasites were detected only by bone marrow examination in one case. Diagnostic sensitivity and specificity of peripheral smears for detecting falciparum infection were 90.6% and 100% respectively while that of the Parasight-F test were 96.8% and 100%, respectively (P>.05). The Parasight-F test has high sensitivity and specificity in diagnosing P. falciparum malarial infection, comparable to or even higher than microscopy exams, particularly in severe and complicated cases, with additional advantages of speed, simplicity and objectivity.
Collapse
|
8
|
Bhagat S, Gaiha M, Sharma VK, Anuradha S. A comparative evaluation of C-reactive protein as a short-term prognostic marker in severe unstable angina--a preliminary study. J Assoc Physicians India 2003; 51:349-54. [PMID: 12723647] [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: 03/02/2023]
Abstract
OBJECTIVE The present study was done to evaluate the short-term prognostic significance of C-reactive protein (CRP) in unstable angina (UA) and to compare it with other known prognostic markers of UA, as there is a paucity of data from our country. METHODOLOGY This prospective study comprised of 44 UA patients (Braunwald Class II A, B) with age < 65 years, along with 40 age and sex matched healthy controls. Patients with h/o myocardial infarction (MI) in the preceding 1-month and evidence of infection, inflammation or neoplasm were excluded from the study. Complete clinical evaluation was done and presence of any prognostic variables of UA was noted (including Brauriwald high-risk variables). Apart from biochemical investigations and ECG, CRP was measured at the time of admission in the study group and controls using Microwell ELISA assay. Standard treatment protocol was followed for all patients and they were closely monitored during hospital stay and subsequently for 4 weeks for occurrence of any adverse cardiac events. RESULTS There was a statistically significant difference in the mean level of CRP between study group (6.12 +/- 6.134 mg/L) and controls (1.52 +/- 0.751 mg/L); p = 0.000. Among the 44 patients, 19 (43%) experienced any one or more outcome measures. Of the three variables (i.e. ongoing chest pain, ST depression > or = 1 mm and CRP > or = 4 mg/L) which showed statistical significance on univariate analysis with respect to adverse outcome measures (p = 0.001, 0.027 and 0.000 respectively), only CRP > or = 4 mg/L and ST depression > or = 1 mm showed independent prognostic significance on multiple logistic regression analysis (p = 0.000 and 0.002 respectively). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and relative risk (RR) for CRP > or = 4 mg/L were 78.9%, 96%, 93.75%, 85.74% and 6.56 (95% CI; 2.62 - 16.4) and that for ST depression > or = 1 mm were 89.47%, 64%, 65.38%, 88.89% and 5.88% (95% CI: 1.54 - 22.38), respectively. Trop T could be done in eight patients only. CONCLUSION CRP > or = 4 mg/L by ELISA is an independent predictor of adverse cardiac outcome in severe UA in the short-term follow up and, hence, is useful for risk stratification of these patients. CRP has a higher specificity, PPV and overall RR for prediction of an outcome than ST segment depression, although it is less sensitive.
Collapse
Affiliation(s)
- S Bhagat
- Department of Medicine, Maulana Azad Medical College, New Delhi
| | | | | | | |
Collapse
|
9
|
Gupta D, Gaiha M, Siddaraju N, Daga MK, Anuradha S. Chronic myeloid leukemia presenting with avascular necrosis of femur head. J Assoc Physicians India 2003; 51:214-5. [PMID: 12725271] [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: 03/02/2023]
Abstract
We report the case of a 15 years girl in whom avascular necrosis (AVN) of right femur head was the presenting feature of chronic stable phase of chronic myeloid leukemia (CML). To date, only three case of CML with AVN have been reported. So, in view of rarity of this condition, a similar case of CML presenting as AVN of femur head is being reported.
Collapse
Affiliation(s)
- D Gupta
- Department of Medicine, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi
| | | | | | | | | |
Collapse
|
10
|
Jain S, Gaiha M, Bhattacharjee J, Anuradha S. Effects of low-dose omega-3 fatty acid substitution in type-2 diabetes mellitus with special reference to oxidative stress--a prospective preliminary study. J Assoc Physicians India 2002; 50:1028-33. [PMID: 12421024] [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: 02/27/2023]
Abstract
BACKGROUND A state of increased oxidative stress has been recognised in type 2 diabetes mellitus (DM). The present study was done to assess the effects of low dose omega-3 fatty acids substitution in patients with type 2 DM with special reference to oxidative stress. METHOD Sixty-five patients with type 2 DM of body mass index (BMI) < 27 kg/m2 and thirty age and sex matched healthy controls were evaluated for blood glucose, blood pressure and lipid profile and oxidative stress was assessed in them by measuring lipid peroxides (LP), diene conjugates (DC) and reduced glutathione (RG) in the serum. Of the 65, 40 motivated patients were randomly divided into two groups--group 1 comprising of fifteen patients prescribed a diabetic diet along with a placebo and group 2 consisting of twenty-five patients on the same diet with the addition of 0.6 g omega-3 fatty acids as one capsule Maxigard (containing 180 mg eicosapentaenoic acid and 120 mg docosahexaenoic acid) twice daily. All parameters were reassessed after six weeks. RESULTS The levels of lipid peroxides (micromol/L), diene conjugates (OD units) and reduced glutathione (mmol GSH/L) were significantly altered indicating increased oxidative stress in the diabetics compared to the healthy controls: 4.106 +/- 0.889, 2.751 +/- 0.424, 1.344 +/- 0.316 and 1.91 +/- 0.541, 1.735 +/- 0.315, 1.919 +/- 0.310, respectively (p < 0.001 for all the three). Patients in group 1 and 2 were comparable in all respects including oxidative stress at the start of therapy. After six weeks, on comparing the mean % changes in the three parameters of oxidative stress between the two groups, it was seen that the % change was significantly higher in group 2 (Maxigard group) compared to group 1 (Placebo; 5.22 +/- 1.056 (p = 0.05), 3.28 +/- 0.608 (p = 0.01), 5.27 +/- 0.585 (p < 0.001) and 0.82 +/- 0.123, 0.18 +/- 0.017, 0.56 +/- 0.035 (p < 0.001), respectively. The patients in group 2 also exhibited significantly greater improvement in glycemic status, blood pressure and lipid profiles. CONCLUSIONS The present study documented the existence of a state of increased oxidative stress in type 2 diabetics. Significant beneficial effects of low dose omega-3 fatty acids substitution for PUFA-6 were observed not only on oxidative stress parameters but also on blood pressure and metabolic profile.
Collapse
Affiliation(s)
- S Jain
- Department of Medicine, MAMC and Associated Lok Nayak and GB Pant Hospitals, New Delhi
| | | | | | | |
Collapse
|
11
|
Arora A, Chowdhury D, Daga MK, Arora N, Gaiha M. Reversible posterior leukoencephalopathy syndrome: a report of 2 cases. Neurol India 2001; 49:311-3. [PMID: 11593254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Reversible posterior leukoencephalopathy syndrome (RPLE) is an increasingly recognised disorder, most commonly associated with malignant hypertension, toxaemia of pregnancy or the use of immunosuppressive agents. Two cases of RPLE syndrome occurring in the setting of accelerated hypertension and eclampsia are described. Both patients had seizures, altered sensorium and typical findings on neuroimaging. They had complete clinical and radiological recovery. The clinical course, pathophysiology and neuroimaging features of RPLE syndrome are discussed.
Collapse
Affiliation(s)
- A Arora
- Department of Neurology, G.B. Pant Hospital, New Delhi-110019, India
| | | | | | | | | |
Collapse
|
12
|
Singh K, Gaiha M, Shome DK, Gupta VK, Anuradha S. The association of antiphospholipid antibodies with ischaemic stroke and myocardial infarction in young and their correlation: a preliminary study. J Assoc Physicians India 2001; 49:527-9. [PMID: 11361266] [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: 04/16/2023]
Abstract
AIM The possible etiological role of antiphospholipid antibodies (APA) in thrombotic events on arterial side has become subject of interest. The present study was undertaken to determine the association and possible etiological role of APA in young Indian patients with acute ischaemic stroke and myocardial infarction (MI). MATERIAL AND METHODS Forty six patients < 40 years of age including 22 with ischaemic stroke (excluding those with rheumatic heart disease and SLE), 24 with an acute MI and 21 age and sex matched healthy controls were enrolled in the study. All the patients and the controls were tested for the presence of lupus anticoagulant (LA) by a lupus sensitive activated partial thromboplastin time (APTT) and kaolin clotting time (KCT) and anti-caridiolipin antibodies (aCL) of IgM and IgG types using an ELISA technique. RESULTS The screening tests for LA with APTT and KCT were negative in all the patients and the normal controls. In the stroke subgroup 18.18% patients (4/22) and in MI subgroup 4.16% (1/24) patients had raised aCL titers with statistically significant association only for stroke subgroup (p=0.0201) and not for MI subgroup. Significantly higher proportion of aCL positive cases were found in patients without any risk factor for atherosclerosis (4/12), compared to patients with one or more risk factor for atherosclerosis (1/34), p=0.001. CONCLUSION Younger patients without identifiable risk factors for atheroscerosis presenting with stroke, are more likely to have an underlying antiphospholipid syndrome (APLS) as the etiology, and should be screened for it. No such association however was observed for MI patients.
Collapse
Affiliation(s)
- K Singh
- Department of Medicine, Maulana Azad Medical College and Associated, Lok Nayak and GB Pant Hospitals, New Delhi
| | | | | | | | | |
Collapse
|
13
|
Nigam S, Rani S, Singh T, Gupta S, Rakheja D, Gaiha M. Clinical, hematological and histomorphological profile of myelodysplastic syndrome. J Assoc Physicians India 2001; 49:430-4. [PMID: 11762613] [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: 02/23/2023]
Abstract
AIM The present study was designed to analyse clinical, haematological and histomorphogical features in 37 cases of myelodysplasic syndrome (MDS). MATERIAL AND METHODS FAB criteria was used to diagnose MDS in 37 patients. Clinical details, peripheral blood findings, bone marrow aspirate and biopsy were reviewed. RESULTS Of 37 cases, there were 25 females and 12 males in age range of 2 years to 75 years. There were three children. There were nine cases of refractory anaemia (RA), 18 of refractory anaemia with excess blasts (RAEB), nine of refractory anaemia with excess blasts in transformation (RAEB-t) and one of chronic myelomonocytic leukemia (CMML). All were denovo MDS. All patients had pallor. Hepato and/or splenomegaly was seen in 15 cases. Anemia, leukopenia and thrombocytopenia was seen in 37, 6 and 23 cases respectively. Bone marrow aspiration (BMA) was hyper to normo cellular in 35 cases. Dyshemopoiesis was seen in one or more cell lines in all cases. Bone marrow biopsy (BMB) was available in 16 cases. Abnormal localisation of immature precursors (ALIP) was seen in 11/12 biopsies of RAEB and 3/4 of RAEB-t. BMB was helpful in diagnosis of 3 doubtful cases (one RAEB and two RAEB-t), and upgrading of 2 cases of RAEB to RAEB-t. On follow up, 1 case of RA, 3 of RAEB, 1 of RAEB-t developed AML. One case of RAEB developed ALL and 2 progressed to RAEB-t. CONCLUSION Primary MDS is seen in all age groups. Pallor is commonest presentation. RAEB was commonest subgroup seen. BMB is helpful in diagnosis of doubtful cases. ALIP is a reliable diagnostic feature of MDS. BMB is a diagnostic as well as prognostic tool in MDS cases which should be taken as a mandatory investigation.
Collapse
Affiliation(s)
- S Nigam
- Department of Pathology, MAM College, New Delhi
| | | | | | | | | | | |
Collapse
|
14
|
Gupta D, Gaiha M, Mahajan R, Daga MK. Atypical presentation of Sheehan's syndrome without postpartum haemorrhage. J Assoc Physicians India 2001; 49:386-7. [PMID: 11291989] [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] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- D Gupta
- Department of Medicine, Maulana Azad Medical College, New Delhi
| | | | | | | |
Collapse
|
15
|
Anuradha S, Prabhash K, Shome DK, Gaiha M, Singh NP, Agarwal SK, Mandal AK, Jain S, Chaturvedi KU, Sawlani KK. Symmetric peripheral gangrene and falciparum malaria--an interesting association. J Assoc Physicians India 1999; 47:733-5. [PMID: 10778599] [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: 02/16/2023]
Abstract
Symmetric peripheral gangrene (SPG) is a rare syndrome in which disseminated intravascular coagulation (DIC) is the most common underlying condition. We report three cases of SPG in association with Plasmodium falciparum malaria and DIC, an association unreported so far.
Collapse
Affiliation(s)
- S Anuradha
- Dept of Medicine, Maulana Azad Medical College, New Delhi, India
| | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Jain S, Bhargava K, Sawlani KK, Daga MK, Gaiha M. Myoglobinuria and transient acute renal failure in a patient revealing hypothyroidism. J Assoc Physicians India 1999; 47:444-6. [PMID: 10778535] [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: 02/16/2023]
Abstract
Muscle involvement in hypothyroidism commonly manifests as fatigue, myalgias, stiffness and slowed reflexes. We report a case of transient acute renal failure related to rhabdomyolysis and myoglobinuria in a 40 year old man that revealed the diagnosis of hypothyroidism with myopathy. The patient had proximal muscle weakness and tenderness, markedly raised muscle enzymes and deranged renal functions that normalised with thyroid replacement therapy. Hypothyroidism, though rare, should be considered a definite and authentic cause of rhabdomyolysis.
Collapse
Affiliation(s)
- S Jain
- Dept. of Medicine, Maulana Azad Medical College, New Delhi
| | | | | | | | | |
Collapse
|
17
|
Sawlani KK, Gaiha M, Jain S, Shome DK, Aggarwal SB, Rani S, Goel S, Prabhash K. Rare presentations of idiopathic myelofibrosis: spontaneous rupture of spleen; pyoderma gangrenosum; and urologic obstruction. J Assoc Physicians India 1998; 46:230-2. [PMID: 11273121] [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] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- K K Sawlani
- Department of Medicine, Maulana Azad Medical College, New Delhi-110 002
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Negi VS, Sarin K, Daga MK, Gaiha M, Sethi Y. A rare case of Aicardi syndrome. J Assoc Physicians India 1994; 42:919-20. [PMID: 7868502] [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] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- V S Negi
- Department of Medicine, Maulana Azad Medical College, New Delhi
| | | | | | | | | |
Collapse
|
19
|
Negi VS, Daga MK, Gaiha M, Mathur RP. Ankylosing spondylitis with lung involvement mimicking pulmonary tuberculosis and rapidly progressing chronic renal failure. J Assoc Physicians India 1994; 42:835-7. [PMID: 7876062] [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] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- V S Negi
- Depat of Medicine, Maulana Azad Medical College, New Delhi
| | | | | | | |
Collapse
|
20
|
Basu D, Singh T, Chopra K, Jain V, Madan N, Sethi GR, Gaiha M. Hemoglobin H disease--a report of five cases. Indian Pediatr 1993; 30:791-3. [PMID: 8132261] [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: 01/29/2023]
Affiliation(s)
- D Basu
- Department of Pathology, Maulana Azad Medical College, New Delhi
| | | | | | | | | | | | | |
Collapse
|
21
|
Singh T, Basu D, Prakash S, Rani S, Gaiha M. Marrow histomorphology and clinical staging of chronic lymphocytic leukemia--a rare disease in India: experience with 26 cases. Leuk Lymphoma 1993; 10:117-9. [PMID: 8374519 DOI: 10.3109/10428199309147364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Chronic Lymphocytic Leukemia is a relatively uncommon hemopoietic malignancy in the Indian subcontinent. We have made an attempt to correlate the morphology of the marrow with staging and clinical course of the disease in 26 cases. Four out of 6 cases in Stage A showed a nodular/interstitial marrow pattern, while 18 out of 20 cases of stage B and C demonstrated a mixed/diffuse involvement of marrow. Cases showing a nodular/interstitial pattern had a relatively benign clinical course even without chemotherapy, while patients with diffuse/mixed marrow pattern required chemotherapy. Trephine histological pattern was found to be a good prognosticator and was useful in segregating cases requiring chemotherapy from those which do not.
Collapse
Affiliation(s)
- T Singh
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | | | | | | | | |
Collapse
|
22
|
Gaiha M, Sethi HP, Sudha R, Arora R, Acharya NR. A clinico-hematological study of iron deficiency anemia and its correlation with hyperviscosity symptoms in cyanotic congenital heart disease. Indian Heart J 1993; 45:53-5. [PMID: 8365742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
The present study was carried out in 33 cases of cyanotic congenital heart disease (CCHD) to determine the prevalence of iron deficiency anemia (IDA) and its correlation to hyperviscosity symptoms in terms of hematocrit levels. Furthermore, the study was aimed at assessing the response to low dose iron therapy (60 mg of elemental iron once daily) in relieving symptoms of hyperviscosity. All these cases were evaluated for presence of symptoms of hyperviscosity and later subjected to various hematological & biochemical parameters of iron deficiency anemia including hemoglobin (Hb), pack cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), serum iron, total iron binding capacity respectively. Results showed presence of IDA in 6/33 cases (18.2%) and hyperviscosity symptoms in 10/33 cases (30.3%). Amongst the group with symptoms of hyperviscosity, in the subset having IDA these symptoms were observed at PCV levels of 0.52 L/L to 0.58 L/L in contrast to the subset not deficient in iron where the symptoms occurred at a PCV 0.68 L/L. Relief of symptoms of hyperviscosity was evident with a minimal rise of mean hemoglobin by 2.1 gm/dl. It was concluded that IDA was not an uncommon finding in CCHD cases and that it leads to symptoms of hyperviscosity at a level of PCV much lower than those known to produce these symptoms. Finally low dose iron therapy was found effective in relieving the symptoms of hyperviscosity.
Collapse
Affiliation(s)
- M Gaiha
- Department of Medicine & Cardiology, Maulana Azad Medical College, LNJPN Hospital, New Delhi
| | | | | | | | | |
Collapse
|
23
|
Singh T, Gaiha M, Prakash S. Hairy cell leukemia (HCL). INDIAN J PATHOL MICR 1992; 35:77. [PMID: 1452254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
|
24
|
Abstract
Budd Chiari Syndrome is the eponymic designation of symptomatic post sinusoidal venous obstruction, whether or not this is associated with hepatic vein occlusion or vena caval obstruction. Dutta and associates (1) classified the syndrome into two distinct types. Type I involves obstruction to the hepatic veins while Type II pertains to an obstruction in the inferior vena cava above the entry of hepatic veins. We report a case of thoraco-abdominal aortic aneurysm presenting as Type II Budd Chiari Syndrome.
Collapse
Affiliation(s)
- D S Samlok
- Department of Medicine, Maulana Azad Medical College, G.B. Pant Hospitals, New Delhi
| | | | | | | | | | | |
Collapse
|
25
|
Shroff K, Gaiha M, Singh T, Sharma SK. Iron status in patients of rheumatoid arthritis with special reference to serum ferritin levels. J Assoc Physicians India 1991; 39:675-7. [PMID: 1814899] [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: 12/28/2022]
Abstract
Thirty patients of rheumatoid arthritis comprising 16 classical and 14 definite cases based on the ARA criteria were evaluated in a prospective and controlled study for iron status with special reference to serum ferritin levels. Serum ferritin levels were estimated by RIA technique and marrow iron status was ascertained by semi-quantitative estimation after Pearl's staining of marrow aspirate (G 0-6). Marrow iron stores were found absent to decreased in 17 patients (56.7%), normal in 2 (6.7%) and increased in 11 patients (36.6%). The serum ferritin levels in the iron depleted rheumatoid arthritis patients were significantly lower in comparison to patients with normal to increased marrow iron stores (23.91 +/- 11.45 ug/L vs 69.94 +/- 24.7 ug/L, p less than 0.001). There was a strong positive correlation between serum ferritin levels and marrow iron stores (r = +0.08, p less than 0.001). A serum ferritin value of less than or equal to 32 ug/L was a good predictor of decreased iron stores in the bone marrow, with a sensitivity of 88.2% and specificity of 84.5%. The test had a predictive value of 83.33%. There was no correlation between marrow iron stores and conventional indicators or iron status i.e. serum iron, TIBC, transferrin saturation and MCHC. It is concluded that serum ferritin correlates well with marrow iron stores and can be used as a simple non-invasive test for predicting iron-deficiency in patients of rheumatoid arthritis.
Collapse
Affiliation(s)
- K Shroff
- Department of Medicine, Medical College and associated LNJPN Hospital, New Delhi
| | | | | | | |
Collapse
|
26
|
Singh B, Verma R, Singh T, Prakash S, Gaiha M, Garg KC. Value of splenic aspirate in the diagnosis of hairy cell leukaemia. J Assoc Physicians India 1990; 38:299-300. [PMID: 2391333] [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: 12/31/2022]
Abstract
We present a case with hairy cell leukaemia which was diagnosed on a splenic aspirate. The patient refused splenectomy.
Collapse
Affiliation(s)
- B Singh
- LNJPN Hospital, Associated MAM College, New Delhi
| | | | | | | | | | | |
Collapse
|
27
|
Singh T, Kochar R, Gaiha M. Estimation of marrow iron stores, biopsy vs. aspirate. J Assoc Physicians India 1989; 37:705-6. [PMID: 2632536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
28
|
Singh T, Harjinder, Gaiha M. Bone marrow biopsy in staging of malignant lymphomas. J Assoc Physicians India 1989; 37:513-4. [PMID: 2621187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Seventy cases of malignant lymphoma studied for bone marrow involvement by Jamshidi needle trephine biopsy are reported. Bone marrow involvement was detected in 27 cases. Bone marrow biopsy helped the advancement of disease to stage IV in 22 cases though they were in stage I-III initially. Jamshidi needle biopsy was found to be a very useful diagnostic tool for detection of lymphoma deposit in the marrow.
Collapse
|
29
|
Jain P, Gaiha M, Ahuja P. Evaluation of therapeutic response with micro dose of vitamin B12 and folic acid in patients of dimorphic anaemia. J Assoc Physicians India 1984; 32:327-9. [PMID: 6746540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
30
|
Abstract
A case of juvenile diabetes mellitus with rhino-orbital mucormycosis treated successfully with amphotericin B is described.
Collapse
|
31
|
Gaiha M, Prakash SK, Bhargava M, Aggarwal A. Acute intermittent porphyria. (A report of five cases). J Assoc Physicians India 1978; 26:199-202. [PMID: 730689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
32
|
Ahuja SK, Sachdev S, Gaiha M. Thrombotic thrombocytopenic purpura. J Indian Med Assoc 1977; 68:126-7. [PMID: 561818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
33
|
Ahuja SK, Gaiha M, Sachdev S, Maheshwari HB. Tubercular colitis simulating ulcerative colitis. J Assoc Physicians India 1976; 24:617-9. [PMID: 1025150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
34
|
Gaiha M, Sharma ID, Saha K, Chuttani HK, Srivastava PN. Post-transfusion hepatitis and hepatitis-associated antigen in New Delphi. Trans R Soc Trop Med Hyg 1974; 68:383-6. [PMID: 4458149 DOI: 10.1016/0035-9203(74)90153-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
|