1
|
Dhawan V, Chandra S, Kala M, Khanduri S. Expression of PD-L1 in Lung Carcinoma and Its Correlation with Histopathological Grade, Stage, and Survival of Patients. J Lab Physicians 2022. [DOI: 10.1055/s-0042-1758665] [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: 12/12/2022] Open
Abstract
Abstract
Objective PD-L1, a 40 kDa type 1 transmembrane protein, suppresses the adaptive arm of the immune system. The interaction of PD-1 with the ligand PD-L1 inhibits cytokine production and plays a role in the progression of lung cancer. The present study was performed to observe the expression of PD-L1 in lung carcinoma patients and its correlation with histopathological grade, stage, and survival of patients.
Materials and Methods This prospective study included all new cases of lung carcinoma diagnosed on histopathological or cytopathological examination over a period of 1 year. PD-L1 immunoexpression was statistically analyzed and graded according to the Tumor Proportion Score in all cases and correlated with histopathological grade, stage, and survival of patients.
Results This study included 56 cases of lung carcinoma with 64.2% cases showing PD-L1 positivity, out of which 44.6% were non-small cell and 19.6% were small cell lung carcinoma. In all, 32.1% cases with lymphovascular invasion, 53.5% with necrosis, and 37.5% cases with greater than 5/10 HPF mitotic figures showed positive PD-L1 expression. Paired cell blocks and histopathology showed 70% concordance for PD-L1 expression. 16.1% cT3N1M0 cases and 25% stage IIIA cases showed PD-L1 positivity. In all, 60.7% patients with positive PD-L1 expression did not survive for 12 months following diagnosis.
Conclusion PD-L1 immunoexpression was increased in lung carcinoma cases and was associated with poor histomorphological features including lymphovascular invasion, necrosis, and increased mitotic activity. PD-L1 correlated with cases having decreased 12-month survival and stage IIIA carcinoma. Thus, it may be useful in the stratification of patients who benefit from the PD-L1 targeted therapy.
Collapse
Affiliation(s)
- Vishesh Dhawan
- Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Smita Chandra
- Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Mansi Kala
- Department of Pathology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Sushant Khanduri
- Department of Respiratory Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| |
Collapse
|
2
|
Sharma D, Khanduri R, Raghuvanshi S, Chandra S, Khanduri S, Jethani V, Kumar M. Clinical, radiological and histopathological profile of patients with endobronchial lesions on fibreoptic bronchoscopy. Monaldi Arch Chest Dis 2022. [DOI: 10.4081/monaldi.2022.2312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 09/13/2022] [Indexed: 11/23/2022] Open
Abstract
Various pulmonary diseases, both benign as well as malignant, manifest in the form of endobronchial lesions on bronchoscopy. Malignancy is frequently the provisional diagnosis in the mind of a chest physician undergoing an endobronchial biopsy. Other benign diseases, however, may present similarly on bronchoscopy and computerized tomography (CT) scan. This observational study was conducted to better understand why there is such a wide range of endobronchial lesions with even more diverse radiological and pathological presentations. The research was carried out at the Department of Respiratory Medicine, Himalayan Institute of Medical Science (HIMS), Swami Ram Nagar, Dehradun. Subjects were recruited from HIMS, Dehradun patients over a 12-month period (August 2020 to July 2021). The study included patients (over the age of 18) who had a fibreoptic bronchoscopy and were found to have an endobronchial lesion. After a thorough history, examination, and application of the inclusion and exclusion criteria. 120 patients were enrolled. The majority of patients were between the ages of 56 and 65, with males outnumbering females. The majority of the patients were smokers, and the most common complaint was shortness of breath. Poorly differentiated carcinoma and squamous cell carcinoma were the most common endobronchial lesions in men, while small cell carcinoma was the most common in women. A mass lesion was the most common radiological finding, followed by mediastinal lymphadenopathy, and an exophytic lesion was the most common endobronchial lesion detected in bronchoscopy. We looked at the diseases that cause endobronchial lesions and their clinico-radiological and histopathological profiles. This study clearly demonstrates the importance of studying the histopathological profiles of patients with endobronchial growth, which can mimic malignancy in rare cases.
Collapse
|
3
|
Kishore N, Modi S, Khanduri S, Kakati B. Urinary tract infection in critically ill patients with diabetes mellitus: Spectrum of uropathogens and antimicrobial susceptibility pattern. Bali J Anaesthesiol 2020. [DOI: 10.4103/bjoa.bjoa_97_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
4
|
Bhargava A, Kaushik R, Kaushik RM, Sharma A, Ahmad S, Dhar M, Mittal G, Khanduri S, Pant P, Kakkar R. Scrub typhus in Uttarakhand & adjoining Uttar Pradesh: Seasonality, clinical presentations & predictors of mortality. Indian J Med Res 2018; 144:901-909. [PMID: 28474627 PMCID: PMC5433283 DOI: 10.4103/ijmr.ijmr_1764_15] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background & objectives: Scrub typhus is a re-emerging mite-borne rickettsiosis, which continues to be underdiagnosed, with lethal consequences. The present study was conducted to determine the seasonality, clinical presentation and predictors of mortality in patients with scrub typhus at a tertiary care teaching hospital in northern India. Methods: Scrub typhus was suspected in patients attending the hospital as per the standard case definition and serological evidence was obtained by performing an IgM ELISA. Results: A total of 284 patients with scrub typhus from urban and rural areas were seen, predominantly from July to November. The most common clinical presentation was a bilateral community-acquired pneumonia (CAP), which resembled pneumonia due to atypical pathogens and often progressed to acute respiratory distress syndrome (ARDS). An acute undifferentiated febrile illness (AUFI) or a febrile illness associated with altered sensorium, aseptic meningitis, shock, abdominal pain, gastrointestinal bleeding or jaundice was also seen. Eschars were seen in 17 per cent of patients, and thrombocytopenia, transaminitis and azotaemia were frequent. There were 24 deaths (8.5%) caused predominantly by ARDS and multi-organ dysfunction. The mortality in patients with ARDS was high (37%). ARDS [odds ratio (OR)=38.29, 95% confidence interval (CI): 9.93, 147.71] and acute kidney injury (OR=8.30, 95% CI: 2.21, 31.21) were the major predictors of death. Interpretation & conclusions: The present findings indicate that scrub typhus may be considered a cause of CAP, ARDS, AUFI or a febrile illness with multisystem involvement, in Uttarakhand and Uttar Pradesh, especially from July to November. Empiric therapy of CAP may include doxycycline or azithromycin to ensure coverage of underlying unsuspected scrub typhus.
Collapse
Affiliation(s)
- Anurag Bhargava
- Department of Internal Medicine, Yenepoya Medical College, Mangaluru, India
| | - Reshma Kaushik
- Department of Medicine, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Rajeev Mohan Kaushik
- Department of Medicine, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Anita Sharma
- Department of Medicine, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Sohaib Ahmad
- Department of Medicine, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Minakshi Dhar
- Department of Medicine, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Garima Mittal
- Department of Microbiology, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Sushant Khanduri
- Department of Critical Care Medicine, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Priyannk Pant
- Department of Medicine, Himalayan Institute of Medical Sciences, Dehradun, India
| | - Rajesh Kakkar
- Department of Medicine, Himalayan Institute of Medical Sciences, Dehradun, India
| |
Collapse
|
5
|
Abstract
Snakebite is considered as a significant public health problem contributing considerably to morbidity and mortality. A neurotoxic snake bite can present from mild ptosis to complete paralysis with external and internal ophthalmoplegia. Three patients presented in emergency intubated outside with deeply comatose, fixed dilated pupil, and absent doll's eye reflex mimicking as brain dead.
Collapse
Affiliation(s)
- Sonika Agarwal
- Department of Critical Care Medicine, HIMS, SRHU, Dehradun, Uttarakhand, India
| | - Nidhi Kaeley
- Department of Medicine, HIMS, SRHU, Dehradun, Uttarakhand, India
| | - Sushant Khanduri
- Department of Critical Care Medicine, HIMS, SRHU, Dehradun, Uttarakhand, India
| | - Nand Kishore
- Department of Critical Care Medicine, HIMS, SRHU, Dehradun, Uttarakhand, India
| |
Collapse
|
6
|
Agarwal S, Kakati B, Khanduri S. Severe Sepsis Due to Chryseobacterium indologenes, a Possible Emergent Multidrug-Resistant Organism in Intensive Care Unit-Acquired Infections. Indian J Crit Care Med 2018; 22:817-819. [PMID: 30598573 PMCID: PMC6259441 DOI: 10.4103/ijccm.ijccm_278_18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 11/04/2022] Open
Abstract
Opportunistic infections in the intensive care unit are quite common which can cause devastating disease in many hospitalized and immunocompromised patients. Chryseobacterium indologenes is one such microorganism which is an emerging cause of nosocomial infections. Many cases had been reported from its infections, but the treatment protocol for its management is still not established. We present two cases of C. indologenes infections which were hospital acquired. The pandrug-resistant nature of the bacteria and the associated mortality were uncommon with these two cases.
Collapse
Affiliation(s)
- Sonika Agarwal
- Department of CCM, H.I.M.S, S.R.H.U., Dehradun, Uttarakhand, India
| | - Barnali Kakati
- Department of Microbiology, H.I.M.S, S.R.H.U., Dehradun, Uttarakhand, India
| | - Sushant Khanduri
- Department of CCM, H.I.M.S, S.R.H.U., Dehradun, Uttarakhand, India
| |
Collapse
|
7
|
Khanduri R, Khanduri S, Kumar S, Saini A, Kotwal A. Drug-resistant tuberculosis coexisting with invasive candidiasis in an immunocompetent 30-year-old woman: A case report. Indian J Tuberc 2017; 64:232-234. [PMID: 28709496 DOI: 10.1016/j.ijtb.2016.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 09/30/2016] [Indexed: 06/07/2023]
Abstract
Invasive candidiasis coexisting with drug-resistant Mycobacterium tuberculosis (DR-TB) in the immunocompetent patient is a rare entity. We report a 30-year-old woman, nondiabetic, who presented to us with complaints of acute onset cough, breathlessness, and fever since 20 days. On thorough investigations, she was diagnosed to be suffering from coexisting drug-resistant tuberculosis and invasive candidiasis. Prompt treatment initiated at right time helped us in saving her life. The unique presentation of this case and that too in an immunocompetent female makes it an interesting case.
Collapse
Affiliation(s)
- Rakhee Khanduri
- Himalayan Institute of Medical Sciences, Pulmonary Medicine, B X/7 HIHT Campus, SRHU, Doiwala, India.
| | - Sushant Khanduri
- Himalayan Institute of Medical Sciences, Pulmonary Medicine, B X/7 HIHT Campus, SRHU, Doiwala, India
| | - Sanjeev Kumar
- Himalayan Institute of Medical Sciences, Pulmonary Medicine, B X/7 HIHT Campus, SRHU, Doiwala, India
| | - Ankur Saini
- Himalayan Institute of Medical Sciences, Pulmonary Medicine, B X/7 HIHT Campus, SRHU, Doiwala, India
| | - Arti Kotwal
- Himalayan Institute of Medical Sciences, Pulmonary Medicine, B X/7 HIHT Campus, SRHU, Doiwala, India
| |
Collapse
|
8
|
Khanduri S, Bhagat S. Multi detector CT evaluation of suspicious malignant lung masses with its combined wash-in & wash-out features and their histopathological correlation. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx086.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
9
|
Agarwal S, Kakati B, Khanduri S, Gupta S. Emergence of Carbapenem Resistant Non-Fermenting Gram-Negative Bacilli Isolated in an ICU of a Tertiary Care Hospital. J Clin Diagn Res 2017; 11:DC04-DC07. [PMID: 28273965 DOI: 10.7860/jcdr/2017/24023.9317] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 09/08/2016] [Accepted: 11/28/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The emergence and spread of Multi-Drug Resistant (MDR) Non-Fermenting Gram-Negative Bacilli (NFGNB) in Intensive Care Units (ICU) and their genetic potential to transmit diverse antibiotic resistance regardless of their ability to ferment glucose poses a major threat in hospitals. The complex interplay of clonal spread, persistence, transmission of resistance elements and cell-cell interaction leads to the difficulty in controlling infections caused by these multi drug-resistant strains. Among non-fermenting Gram-negative rods, the most clinically significant species Pseudomonas aeruginosa, Acinetobacter baumannii and Stenotrophomonas maltophilia are increasingly acquiring resistant to carbapenems. Carbapenems once considered as a backbone of treatment of life threatening infections appears to be broken as the resistance to carbapenems is on rise. AIM To document the prevalence of carbapenem resistance in non-fermenting Gram-negative bacilli isolated from patients with respiratory tract infections in the ICU of Himalayan Institute of Medical Sciences, Dehradun. MATERIALS AND METHODS This is a cross-sectional study conducted in ICU patients between October 2015 to March 2016. A total of 366 lower respiratory tract samples were collected from 356 patients with clinical evidence of lower respiratory tract infections in form of Endotracheal (ET) aspirate, Tracheal Tube (TT) aspirate and Bronchoalveolar Lavage (BAL) specimen. Organism identification and the susceptibility testing was done by using an automated system VITEK 2. RESULTS Out of 366 samples received 99 NFGNB were isolated and most common sample was ET aspirate sample 256 (64.5%). Acinetobacter baumannii was the most common NFGNB isolated 63 (63.63%) followed by Pseudomonas aeruginosa 25 (25.25%), Elizabethkingia meningoseptica seven (7.07%) and Strenotrophomonas maltophilia four (4.04%). We observed that 90.5% Acinetobacter baumannii were resistant to imipenem and 95.2% resistant to meropenem, Pseudomonas aeruginosa came out to be 52% resistant to imipenem and 56% resistant to meropenem while Stenotrophomonas maltophilia and Elizabethkingia meningoseptica were 100% resistant to carbapenems as they are intrinsically resistant to carbapenems. CONCLUSION The resistance rate of carbapenems for NFGNB infections is very high in our study and variable in different regions. Overall carbapenem resistance is on rise. So, the infection control team and microbiologist needs to work together to determine the risk carried by multi drug resistant non-fermenting gram-negative infections and the resistance surveillance programs are mandatory to control these bacteria in ICU settings.
Collapse
Affiliation(s)
- Sonika Agarwal
- Assistant Professor, Department of Critical Care Medicine, Himalayan Institute of Medical Sciences, SRHU , Dehradun, Uttarakhand, India
| | - Barnali Kakati
- Associate Professor, Department of Microbiology, Himalayan Institute of Medical Sciences, SRHU , Dehradun, Uttarakhand, India
| | - Sushant Khanduri
- Assistant Professor, Department of Critical Care Medicine, Himalayan Institute of Medical Sciences, SRHU , Dehradun, Uttarakhand, India
| | - Shalini Gupta
- Senior Resident, Department of Microbiology, Himalayan Institute of Medical Sciences, SRHU , Dehradun, Uttarakhand, India
| |
Collapse
|
10
|
Sindhwani G, Sodhi R, Saini M, Jethani V, Khanduri S, Singh B. Tracheobronchomalacia/excessive dynamic airway collapse in patients with chronic obstructive pulmonary disease with persistent expiratory wheeze: A pilot study. Lung India 2016; 33:381-4. [PMID: 27578929 PMCID: PMC4948224 DOI: 10.4103/0970-2113.184870] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Tracheobronchomalacia (TBM) refers to a condition in which structural integrity of cartilaginous wall of trachea is lost. Excessive dynamic airway collapse (EDAC) is characterized by excessive invagination of posterior wall of trachea. In both these conditions, airway lumen gets compromised, especially during expiration, which can lead to symptoms such as breathlessness, cough, and wheezing. Both these conditions can be present in obstructive lung diseases; TBM due to chronic airway inflammation and EDAC due to dynamic compressive forces during expiration. The present study was planned with the hypothesis that TBM/EDAC could also produce expiratory wheeze in patients with obstructive airway disorders. Hence, prevalence and factors affecting presence of this entity in patients with obstructive airway diseases were the aims and objectives of this study. MATERIALS AND METHODS Twenty-five patients with obstructive airway disorders (chronic obstructive pulmonary disease [COPD] or bronchial asthma), who were stable on medical management, but having persistent expiratory wheezing, were included in the study. They were evaluated for TBM/EDAC by bronchoscopy and computed tomographic scan of chest. The presence of TBM/EDAC was correlated with variables including age, sex, body mass index (BMI), smoking index, level of dyspnea, and severity of disease. RESULTS Mean age of the patients was 62.7 ± 7.81 years. Out of 25 patients, 14 were males. TBM/EDAC was found in 40% of study subjects. Age, sex, BMI, severity of disease, frequency of exacerbations and radiological findings etc., were not found to have any association with presence of TBM/EDAC. CONCLUSION TBM/EDAC is common in patients with obstructive airway disorders and should be evaluated in these patients, especially with persistent expiratory wheezing as diagnosis of this entity could provide another treatment option in these patients with persistent symptoms despite medical management.
Collapse
Affiliation(s)
- Girish Sindhwani
- Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Rakhee Sodhi
- Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Manju Saini
- Department of Radiodiagnosis, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Varuna Jethani
- Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Sushant Khanduri
- Department of Pulmonary Medicine, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Baltej Singh
- Lecturer Biostatistics, Guru Gobind Singh Medical College, Baba Faridkot University, Faridkot, Punjab, India
| |
Collapse
|
11
|
Owen G, Khanduri S, Pettit L. Daily image matching of surgical clips improves breast cancer radiotherapy treatment accuracy. Clin Oncol (R Coll Radiol) 2016. [DOI: 10.1016/j.clon.2016.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
12
|
Pettit L, Welsh A, Khanduri S. EP-1172: Thyroid tolerance in adjuvant supraclavicular fossa nodal radiotherapy in breast cancer. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32422-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
13
|
Kumar D, Agarwal S, Karoli R, Siddiqui M, Shukla V, Khanduri S. Relationship between carotid intima thickness and silent cerebral infarction in patients with type 2 diabetic nephropathy. J Assoc Physicians India 2014; 62:316-322. [PMID: 25327034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM To examine the relationship between carotid intima media thickness (CIMT) and silent cerebral infarction (SCI) in order to determine whether CIMT is a predictor of SCI in patients of type 2 diabetic nephropathy. METHODS A total of 80 patients of type 2 diabetic nephropathy were selected on the basis of fasting and 2-hour post-prandial blood sugar, 24 hrs albumin estimation in urine, urea and creatinine in the serum. The selected candidates underwent MRI brain and carotid B mode ultrasonography to find out the event of SCI and to evaluate the CIMT respectively. RESULTS The SCI was found in 30 (37.5%) patients with type 2 diabetic nephropathy. The mean age, BMI, blood pressure (BP), macroalbuminuria, S. lipids, low GFR, duration of diabetes and CIMT were significantly higher in the subject with SCI than in those without it. Multiple logistic analyses indicated that age, BP, and CIMT were found to be significant and independent risk factors of SCI in type 2 diabetic nephropathy subjects. CONCLUSION CIMT is a surrogate and reliable predictor of higher risk of SCI among type 2 diabetic nephropathy patients.
Collapse
|
14
|
Sodhi R, Khanduri S, Nandha H, Bhasin D, Mandal AK. Brain death--think twice before labeling a patient. Am J Emerg Med 2011; 30:1321.e1-2. [PMID: 21802886 DOI: 10.1016/j.ajem.2011.05.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 05/12/2011] [Indexed: 11/19/2022] Open
Abstract
Brain death is defined as the cessation of cerebral and brainstem function. A 12-year-old boy presented with alleged history of snake bite. He was brain dead with Glasgow Coma Score of 3 and absent corneal reflexes. However, it was only neuroparalytic effect of the venom, which improved in due course of time with antivenoms. This case highlights the occurrence of both internal and external ophthalmoplegia, which would mimic brain death in many ways, thus prompting an intensivist to consider withdrawing ventilatory support, which would be disastrous.
Collapse
Affiliation(s)
- Rakhee Sodhi
- Department of Pulmonary Medicine, GMCH, Chandigarh, India.
| | | | | | | | | |
Collapse
|
15
|
Abstract
We present a case of severe H1N1 influenza with hypoxemic acute respiratory failure necessitating mechanical ventilation benefited from noninvasive positive pressure ventilation (NIPPV). The NIPPV may be of great use in treating patients with H1N1-related acute respiratory distress syndrome in a resource poor setting or when invasive ventilator is unavailable.
Collapse
Affiliation(s)
- Prasanta R Mohapatra
- Department of Pulmonary Medicine, Government Medical College and Hospital, Chandigarh, India
| | | | | | | | | |
Collapse
|
16
|
Parashari UC, Khanduri S, Bhadury S, Sarkar P. MRI Manifestation and Early Diagnosis of Bone Infarct: A Rare Complication of Steroid Therapy for Pemphigus. Malays Orthop J 2011. [DOI: 10.5704/moj.1107.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
17
|
Mohapatra P, Dutt N, Khanduri S, Mishra B, Janmeja A. Authors′ reply. Lung India 2011; 28:151-2. [PMID: 21712933 PMCID: PMC3109845 DOI: 10.4103/0970-2113.80341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
18
|
Mohapatra PR, Khanduri S, Dutt N, Sharma P, Janmeja AK. Diagnostic dilemma of antineutrophil cytoplasmic antibody seropositivity in human immunodeficiency virus infection. Indian J Chest Dis Allied Sci 2011; 53:55-57. [PMID: 21446226] [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: 05/30/2023]
Abstract
We present a case of a 48-year-old male who was diagnosed and treated for Wegener's granulomatosis on the basis of history, clinical features, computed tomography (CT) and antineutrophil cytoplasmic antibodies (ANCA) positivity. The patient initially improved and later on during course of the disease he was found to be human immunodeficiency virus (HIV) seropositive. The potential pitfalls of cANCA in a HIV-infected patient are discussed.
Collapse
Affiliation(s)
- Prasanta R Mohapatra
- Department of Pulmonary Medicine, Government Medical College and Hospital, Chandigarh, India.
| | | | | | | | | |
Collapse
|
19
|
Sharma P, Janmeja A, Chavan BS, Mohapatra PR, Khurana AK, Khanduri S. Depression and Anxiety in Obstructive Sleep Apnoea. Chest 2010. [DOI: 10.1378/chest.10171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
20
|
Mohapatra PR, Janmeja AK, Sharma P, Khanduri S, Khurana AK, Dutt N, Aggarwal D. Factors Associated With Hospital Admission in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Chest 2010. [DOI: 10.1378/chest.10474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
21
|
Arshad F, Musa O, Fatima U, Khanduri S. 623 Barriers affecting uptake of breast cancer screening in women of rural India and their impact on the disease: experience from the breast cancer screening services of a teaching hospital. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70643-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
|
22
|
Janmeja AK, Singh AK, Dutt N, Khanduri S, Sharma P, Mohapatra PR, Saini VK. METABOLIC SYNDROME AND OBSTRUCTIVE SLEEP APNEA (SYNDROME Z): STUDY FROM A NORTH INDIAN HOSPITAL. Chest 2009. [DOI: 10.1378/chest.136.4_meetingabstracts.65s-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
23
|
Singh AK, Janmeja AK, Lehl SS, Dass A, Goel NK, Mohapatra PR, Khanduri S. OBSTRUCTIVE SLEEP APNEA IN RESISTANT HYPERTENSION COMPARED TO THAT IN CONTROLLED HYPERTENSION. Chest 2008. [DOI: 10.1378/chest.134.4_meetingabstracts.p71002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
24
|
Abstract
AIMS Recent evidence shows aromatase inhibitors (AIs) to be of benefit over tamoxifen in the adjuvant setting. It is also apparent that musculoskeletal symptoms associated with AIs may be a significant problem in the clinical setting. The aim of this article is to review the data on AIs with respect to musculoskeletal symptoms in the adjuvant setting. MATERIAL AND METHODS A review on the literature relating to AIs in the adjuvant setting and musculoskeletal symptoms. RESULTS Results of phase III trials show lower incidence of musculoskeletal symptoms than reported in the clinical setting. DISCUSSION AIs offer a significant advantage over tamoxifen. More research is required to ascertain the cause and to define the spectrum of musculoskeletal symptoms reported in women taking AIs. Decision of appropriate treatment should be made jointly between clinician and patient after full discussion of the risks and benefits.
Collapse
Affiliation(s)
- S Khanduri
- Cookridge Hospital, Yorkshire Centre of Clinical Oncology, Hospital Lane, Leeds LS16 6QB, UK.
| | | |
Collapse
|
25
|
Khanduri S, Gerrard G. Defining the Standard of Care for High-grade Glioma — a NICE Deal for UK Patients? Clin Oncol (R Coll Radiol) 2007; 19:507-8. [PMID: 17618095 DOI: 10.1016/j.clon.2007.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2007] [Revised: 04/13/2007] [Accepted: 05/15/2007] [Indexed: 11/28/2022]
|
26
|
O'Toole L, Khanduri S, Gerrard GE. A Small Proportion of Glioblastoma Patients are Probably Eligible for Concomitant/Adjuvant Temozolomide. Clin Oncol (R Coll Radiol) 2007; 19:269. [PMID: 17433972 DOI: 10.1016/j.clon.2007.01.441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2007] [Accepted: 01/25/2007] [Indexed: 10/23/2022]
|
27
|
Khanduri S, Gerrard G, Barton R, Mulvenna P, Lee SM. Clinical Trials Assessing the Optimal Management of Brain Metastases — the State of Play. Clin Oncol (R Coll Radiol) 2006; 18:744-6. [PMID: 17168209 DOI: 10.1016/j.clon.2006.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
These three clinical trials offer the opportunity to answer the controversies and uncertainties that exist in managing patients with brain metastases: for patients with solitary brain metastasis there is the EORTC trial, for patients with NSCLC, where there is a certainty that the patient should receive radiotherapy, there is TACTIC, and where there is uncertainty of the benefit of radiotherapy there is QUARTZ. We would encourage all clinical oncologists seeing patients with brain metastases to consider patients for entry into any one of these trials.
Collapse
|
28
|
Roy AK, Khanduri S, Girisha KM. Fusiform swellings of fingers in a 3-year-old girl. J Postgrad Med 2006; 52:314, 324. [PMID: 17102559] [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: 05/12/2023] Open
Affiliation(s)
- A K Roy
- Department of Pediatrics, Era's Lucknow Medical College, Lucknow, India
| | | | | |
Collapse
|
29
|
Khanduri S. Radiological quiz - chest. Indian J Radiol Imaging 2005. [DOI: 10.4103/0971-3026.29188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|