Browsing by Author "Kashyap, S"
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Item Acute mountain sickness.(1991-07-01) Kashyap, SItem Acute mountain sickness. Reply from the author.(1990-02-01) Kashyap, SItem Airway response to methacholine inhalation in asymptomatic male smokers.(1985-10-01) Jindal, S K; Kashyap, S; Malik, S KItem Chronic bronchitis in rural hills of Himachal Pradesh, northern India.(1986-04-01) Malik, S K; Kashyap, SItem Clinical and bacteriological profile of community acquired pneumonia in Shimla, Himachal Pradesh.(2004-01-12) Bansal, S; Kashyap, S; Pal, L S; Goel, ABACKGROUND: Community acquired pneumonia (CAP) is a common clinical problem. The present study was designed to evaluate the clinical and bacteriological profile of CAP in Shimla. METHODS: Seventy patients with community acquired pneumonia were enrolled in this study. In all the patients blood culture, sputum culture, pleural fluid culture (if available) and serological studies for the detection of Mycoplasma pneumoniae specific IgM antibodies by enzyme linked immunosorbent assay (ELISA) were done. RESULTS: Of the 70 patients, 53 (75.6%) had an identifiable atiology with 12 patients having evidence of mixed infection. No organisms could be isolated in 17 patients inspite of using serological methods for Mycoplasma pneumoniae, invasive procedures like bronchoscopic aspirations in addition to the conventional methods like sputum culture, blood culture and pleural fluid culture. The most frequent pathogen was Streptococcus pneumoniae (n = 19; 35.8%) followed by Klebsiella pneumoniae (n = 12; 22%), Staphylococcus aureus in (n=9; 17%), Mycoplasma pneumoniae (n = 8; 15%), Escherichia Coli (n = 6; 11%), beta-haemolytic streptococci (n = 4; 7.5%) and other Gram-negative bacilli (n = 5, 9%). CONCLUSION: Age smoking and under lying co-morbid conditions specially chronic obstructive pulmonary disease (COPD) were significantly associated with the development of CAP (p < 0.01).Item Drug interaction--induced osteonecrosis of femoral head.(1990-06-01) Patial, R K; Bansal, S K; Kashyap, S; Negi, AItem Effect of fiberoptic bronchoscopy on arterial blood gases and cardiac rhythm at a moderate altitude of 2250 meters.(1999-11-22) Sharma, G D; Bansal, S K; Kashyap, S; Kapoor, DOBJECTIVES: To study the effects of fiberoptic bronchoscopy (FOB) at an altitude of 2250 m on arterial blood gases (ABG) and cardiac rhythm abnormality. METHODS: Fifty consecutive patients undergoing fiberoptic bronchoscopy were evaluated for the arterial blood gases and cardiac rhythm changes at Shimla (a moderate altitude of 2250 m), where there is a state of ambient hypoxia. RESULTS: The changes were noted in five stages ranging from the levels before the procedure till 15 minutes after the completion of the procedure. The mean fall in PaO2 levels in this study was 8 +/- 2.45 mm Hg and the fall was maximum at the end of procedure. Both smokers and nonsmokers showed a significant fall but the fall was more severe in smokers. The mean fall in SaO2 in this study was 3%. The increase in heart rate and blood pressure during FOB was significant as compared to baseline levels. There was no significant change in PH, PaCO2, HCO3. The commonest rhythm abnormality noted was sinus tachycardia which was well tolerated. No major cardiac arrhythmia was noted. It was further seen that the duration of the procedure and type of special procedure undertaken did not effect the levels significantly. Cyanosis was the commonest complication encountered (36%) and was seen more frequently in smokers and those with age more than 40 years. It was observed during the induction of bronchoscope and also during the further negotiation of the bronchoscope into the smaller branches of bronchial tree. CONCLUSION: The changes in ABG and cardiac rhythm are comparable to the studies at sea level except the increased incidence of cyanosis.Item Effect of ipratropium bromide (atrovent) inhalation in chronic bronchitis.(1985-07-01) Kashyap, S; Jindal, S K; Malik, S KItem Effectiveness of salmeterol in stable COPD.(1999-10-08) Kaushik, M L; Kashyap, S; Bansal, S K; Sharma, AThirty patients of stable chronic obstructive pulmonary disease (COPD) were studied for evaluation of effectiveness of inhaled salmeterol in a double blind, randomised, placebo controlled trial for seven days. Baseline spirometery and breathlessness score after 6 minutes walk test were assessed in all patients. Bronchial asthma was excluded in each patient by reversibility test with 200 ug of salbutamol inhalation. After inhalation of two puffs from a given inhaler through spacer device in the morning, spirometery was carried out 1, 3, 6 and 12 hrs after inhalation on day 1, 3 and 7 of trial. Six minutes walk test and breathlessness score were assessed after 3 hrs of inhalation on days 1, 3 and 7. The maximum bronchodilator response to salmeterol was observed on 7th day at three hours after inhalation. The mean increase in FEV1 was 29.2% of baseline value, which was significant as compared to placebo where the mean increase in FEV1 was 3.3% of the baseline value. The peak rise in FEV1 was observed at three hours after inhalation on all the three days. The bronchodilator effect of salmeterol persisted for upto 12 hours. The mean maximum increase in walking distance in 6 minutes walk test was observed on 7th day in salmeterol group, which was 50.7 metres whereas in placebo group it was 12.2 meters. The patients in salmeterol group perceived less breathlessness after the six minutes walk test. The study concluded that salmeterol 50 micrograms twice a day is effective in improving lung functions in patients with stable COPD and can be recommended as maintenance therapy for stable COPD patients.Item Electrocardiographic findings in healthy adults residing at high altitudes in the Himalayas.(1988-10-01) Singhal, S K; Puri, D S; Kashyap, S; Kaushal, S; Kaul, J; Sharma, AItem Electronic Cigarettes: Facts and Myths.(2014-10) Solanki, Anjali; Kashyap, K; Kashyap, SE-cigarettes are devices designed to deliver nicotine to users without burning tobacco. These are being marketed globally as a healthier substitute to the conventional cigarettes and as smoking quitting aids. The use of these devices has increased recently in developed countries with approximately 1.3 million users reported in the United Kingdom in 2013. Perception of these products as a safe alternative, appealing advertisements, and lax regulatory policies have helped gain popularity among the public. Despite all these claims, a debate is on-going because of insufficient scientific data regarding safety and efficacy of e-cigarettes as well as awareness of the potential health hazards. To solve the dilemma, more scientific studies in this field are required. Prompt regulatory response with strict vigilance on marketing and advertising may be desirable in the interest of users and public at large.Item Endoillumination (chandelier) and wide-angle viewing-assisted fine-needle aspiration biopsy of intraocular mass lesions(All India Ophthalmological Society, 2018-06) Venkatesh, P; Kashyap, S; Temkar, S; Gogia, V; Garg, G; Bafna, RKFine-needle aspiration biopsy (FNAB) of intraocular mass lesions is an important intervention in the presence of diagnostic difficulty. FNAB of intraocular mass lesions is also likely to become more commonly recommended for prognostication of tumors such as choroidal melanoma. The most commonly described approach for tumor localization and visualization during FNAB is transillumination and indirect ophthalmoscopic viewing. Herein, we report endoillumination (chandelier) and wide-angle viewing assisted, microscope-based approach for FNAB in two patients using two port minimally invasive vitreoretinal surgical approach. The submission is supported by a video demonstration. The entire procedure was completed under the microscope. Adequate sample was obtained. In the first patient, the inflammatory nature of the lesion was confirmed though magnetic resonance imaging had been reported as melanoma. In the second patient, a clinical diagnosis of amelanotic melanoma was confirmed. Endoillumination-assisted FNAB of intraocular mass lesions is easier to learn and more precise and hence carries lesser risks.Item Flexible fiberoptic bronchoscopy in clinical practice--a review of 100 procedures.(1985-07-01) Jindal, S K; Behera, D; Dhand, R; Kashyap, S; Malik, S KItem Gastric acid state and gastroduodenal changes in chronic obstructive pulmonary disease.(1987-04-01) Singhal, S K; Puri, D S; Pal, S L; Kashyap, S; Gupta, R RItem Gastrointestinal mucormycosis--an uncommon isolated mucormycosis.(1998-10-31) Sharma, M C; Gill, S S; Kashyap, S; Kataria, R; Gupta, D K; Sahni, P; Acharya, S KBACKGROUND: Isolated mucormycosis of the gastrointestinal tract is uncommon, with only two case reports from India. OBJECTIVES: To study the clinicopathologic features of gastrointestinal mucormycosis in Indian patients. METHODS: Eight cases of isolated gastrointestinal mucormycosis, seen over six years (1992-97) are reviewed. RESULTS: Five of the patients were premature babies or infants, one was a 12-year-old boy, and two were middle aged. Symptomatology included vomiting, bloody diarrhea, upper gastrointestinal bleeding, abdominal lump and abdominal distention. All the neonates presented with intestinal perforation. The duration of symptoms was ten days or less in six cases. Mucormycosis was not suspected clinically in any patient. In six cases the diagnosis was established antemortem from resection or biopsy material. Only two patients received antifungal therapy and only one patient responded. CONCLUSIONS: Isolated gastrointestinal mucormycosis is not uncommon in India. Early diagnosis may be helpful in reducing the high mortality.Item Hydatid disease of the lung mimicking a pericardial cyst.(2008-07-18) Mohapatra, P R; Negi, R S; Kanwar, R S; Kashyap, SWe report a young girl who presented to us with chest discomfort and had a paracardiac mass on chest radiograph. Computerised tomographic (CT) scan of the thorax was suggestive of pericardial cyst. Hydatid serology was negative. The cyst was excised.Item Hypoglycaemia following zinc phosphide poisoning.(1990-04-01) Patial, R K; Bansal, S K; Kashyap, S; Sharma, A K; Sharma, BTwo cases with severe hypoglycaemia following zinc phosphide poisoning are reported. Both patients succumbed to toxic myocarditis.Item Infant feeding practices in a relocated slum--a pilot study.(2003-06-26) Sethi, V; Kashyap, S; Seth, VItem Limited Wegener's granulomatosis presenting as multiple lung nodules.(2004-01-12) Kaushik, Madan L; Sinha, Parmod K; Pandey, D; Pal, L S; Kashyap, SItem Lyme disease in a Shimla boy.(1990-07-01) Patial, R K; Kashyap, S; Bansal, S K; Sood, AA patient with Lyme disease is described. He presented with meningitis-like picture, arthritis, and carditis (congestive cardiac failure and variable AV blocks without valvular lesions). Borrelia was present in the peripheral blood smear.