Browsing by Author "Pai, R"
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Item Biological studies on leukemia in the ICRC mouse. 3. Effect of progesterone administration on leukemia development.(1972-09-01) Pai, R; Ranadive, K JItem Clinicopathologic features of non-small cell lung cancer in India and correlation with epidermal growth factor receptor mutational status.(2013-04) Bhatt, A D; Pai, R; Rebekah, G; Nehru, G Arun; Dhananjayan, S; Samuel, A; Singh, A; Joel, A; Korula, A; Chacko, R TINTRODUCTION: We performed retrospective analysis of 106 patients with lung cancer for which formalin‑fixed paraffin‑embedded tissues was available. Their epidermal growth factor receptor (EGFR) mutation status and treatment outcomes are described. MATERIALS AND METHODS: All patients with confirmed non–small cell lung cancer (NSCLC) during Jan 2008 to Dec 2010 were included. EGFR sequencing was performed with ABI PRISM 310 genetic analyzer. RESULTS: Forty‑two (39.6%) patients had mutation in one of the four exons characterized. Patients whose EGFR mutational status was not available at presentation before the start of treatment were started on chemotherapy, n = 46 (43.39%). If EGFR mutational analysis was available and mutations were present, the patients were started on either upfront tyrosine kinase inhibitor (TKI), n = 15 (14.15%) or if on chemotherapy arm were allowed to finish six cycles and then start with maintenance TKIs, n = 26 (24.52%). The median progression free survival for patients with and without mutations was 11 months (95% CI,7-14) and 9 months (95% CI,7-10) respectively. A median PFS of 14 months (95%CI, 12-16) was seen in the mutation‑positive group that received both chemotherapy followed by switch maintenance with TKIs versus 8 months (95%CI, 7-8 months) in the group that received only TKI. CONCLUSION: The prevalence of EGFR mutations in this population of NSCLC patients was 39.6% with exon 19 mutation being the most common. The observed benefit of addition of chemotherapy over TKI in EGFR mutation‑positive group raises the question, can we offer the therapy of chemotherapy–TKI combination to EGFR mutation‑positive lung cancer patients as shown in the present study.Item Epidemiological typing of Streptococcus pneumoniae from various sources in India & Korea using Box A PCR fingerprinting.(2002-11-25) Lalitha, M K; Shomita, M; Pai, R; Thomas, K; Song, J H; ,BACKGROUND & OBJECTIVES: Epidemiological typing of Streptococcus pneumoniae is necessary to study genetic relatedness among strains. The Box A PCR assay, a good epidemiological tool for high resolution typing of pneumococcal isolates, was used for comparison of strains of S. pneumoniae from Korea, an area of high penicillin resistance and India with low resistance to penicillin. METHODS: The pneumococcal strains from Indian and Korean sources included in the study belonged to serotypes 19F, 23F, 6A & 6B. The penicillin susceptibility of the strains was confirmed by determination of minimum inhibitory concentration values. The strains were then fingerprinted using the Box A PCR protocol and the results were further analysed by Molecular Analyst Software. RESULTS: The Box fingerprinting technique produced sharp, clear and reproducible banding patterns for strains of S. pneumoniae included in the study. There was no similarity between Indian and Korean strains at the genetic level. Among the Korean strains with similar serotypes, the level of similarity varied. Except for one pair (serotype 23F), that showed a level of homology of about 90 per cent, almost all the others showed less than 80 per cent homology. It was also seen that there was a high percentage of homology (> 90% in nasopharyngeal isolates from India belonging to serotype 19F) between isolates from similar source. Comparison of the Indian and Korean isolates of similar serotype showed low homology, except for one cluster of two strains with serotype 6B which showed 84 per cent homology (blood isolates from India and Korea). INTERPRETATION & CONCLUSION: Box A PCR is a highly discriminatory and useful method for typing S. pneumoniae. The results of the study have shown low levels of homology between strains from within India and also between two geographically distinct areas.Item For how long should a multibacillary leprosy patient be treated?(1989-10-01) Ganapati, R; Pai, R; Gandewar, K L; Thressia, X JItem Haemangiopericytoma--an unusual tumour--a report of 5 cases.(2001-01-02) Saldanha, P; Pai, RHaemangiopericytoma (HPC) has remained a controversial entity ever since its first description. The main histological criterion to diagnose this entity is the characteristic vascular pattern highlighted by the reticulin stain. Since this pattern can be present in several other connective tissue tumours, it is basically a diagnosis of exclusion. Electron microscopy has however been helpful in some cases.Item Insulinoma.(1992-10-01) Halder, P J; Hafeezunnisa, P; Pai, R; Samsi, A BA case of insulinoma who had episoic bizarre behaviour is presented here. Pre-operative fasting and two hour post-prandial blood sugar values indicated hypoglycemia with inappropriately high insulin levels. USG and CT scan of the abdomen revealed a tumor of head of the pancreas. The tumour was enucleated surgically. Histopathological examination confirmed the origin as islet cells. The post-operative blood sugar and insulin levels were found to be in normal range. Since insulinoma is a rare pancreatic tumor, differential diagnoses along with a brief review of the literature is also presented.Item Leprosy survey in industries in Bombay.(1989-07-01) Revankar, C R; Gupta, V; Deshpande, S S; Pai, R; Ganapati, RPopulation surveys for leprosy in industrial cities like Bombay revealed that about 60% of adult subjects especially males could be examined. The fact that the prevalence rate of leprosy particularly multibacillary type is much higher in this segment of population as compared to other groups indicates the importance of examining this population at their workspot like industries. 22287 industrial workers were examined for leprosy by paramedical auxiliaries in their establishments and 270 leprosy cases were detected (P.R. 12/1000). However, only 13 multibacillary cases (P.R. 0.5/1000) could be unearthed. 12 patients were with grade II and above. 184 (83%) were untreated. 161 (60%) patients reported for treatment. With available resources, case holding of patients who are not within the control area of the project becomes a challenging job for paramedical workers though large number of leprosy cases are detected amongst industrial workers. If industrial management arranges treatment for leprosy patients without dislocating them from their service, the pool of infection in the urban community will be reduced and can contribute tremendously towards urban leprosy control programme.Item Mesothelial cyst at porta hepatis.(2001-01-24) Augustine, A J; Pai, R K; Pai, R; Diaz, E A; Prabhu, H S; Swaroop, RMesothelial cysts are fluid-filled sacs lined by mesothelial cells. They are rare lesions that have been known to occur at various sites, but have not been reported at the porta hepatis. We report a 45-year-old woman with mesothelial cyst at the porta hepatis that was detected incidentally during open cholecystectomy.Item Multiple meningiomas--a case report.(1996-12-01) Bansal, R; Raghuveer, C V; Pai, RItem Our experience with epidural steroid injections in management of low backpain and sciatica.(2005-10-02) Runu, R; Sinha, N K; Pai, R; Shankar, P R; Vijayabhaskar, PBACKGROUND: Low back pain and sciatica is a common clinical condition. It is a most common orthopaedic complaint in the Kaski region of Nepal. The reason for its increased incidence may be hilly terrain, difficult working and living environment of the region. The initial treatment of Low back pain is conservative. Epidural steroid injection is being slowly established as are liable mode of conservative management in many orthopaedic centres of the world. This is a preliminary report of on-going study of the use of epidural steroid in the management of low back pain cases coming to the orthopaedic department of Manipal Teaching Hospital. METHODS: Prospective clinical trial was carried out on the patients reporting with low back pain and sciatica not responding to other modes of conservative treatment. Pre and post injection evaluation was done clinically. The level of pain, improvement in physical signs and ability to do activities of daily living were noted. RESULTS: Fifty two patients were observed for the average duration of 2.87 months. Average duration of symptoms was for 10 months. After first epidural steroid injection 83% of patients reported relief on day one. In some cases the onset of analgesia was delayed. Four patients reported no relief after first injection. Fifteen patients were given two injections and four received three injections. The average duration between two injections was three weeks.Average duration of pain relief was 20 days. At the end of 3 months, good results were seen in 39%, fair in 33% and bad results in 27%. Overall 59% of patients were able to do activities of daily living. Three patients (5.76%)required operation for disc prolapse. Postoperatively two patients reported back with back pain. Most common complaint of patients after injection was pain at the injection site. No major complications were encountered. CONCLUSION: Epidural Steroid Injection is a safe and effective mode of treatment of Low Back Pain. It provides painfree period to enable the patient for physiotherapy which helps in early recovery.Item Prescribing patterns in the orthopaedics outpatient department in a teaching hospital in Pokhara, western Nepal.(2007-01-08) Shankar, P R; Pai, R; Dubey, A K; Upadhyay, D KOBJECTIVES: Information on the utilization patterns of drugs in the orthopaedics outpatient department (OPD) are lacking in hospitals in western Nepal. The present study was carried out to obtain demographic information about the respondents selected for analysis, information on the average number of drugs prescribed and the average cost of drugs per prescription. The prescriptions were critically analyzed using predetermined criteria. MATERIALS AND METHODS: The study was carried out over a four-month period (01.09.2002 to 31.12.2002) at the Manipal Teaching hospital, Pokhara, Nepal. The percentage of encounters with an injection or an antibiotic prescribed was noted. The percentage of drugs prescribed from the Essential drug list of Nepal and the mean cost of drugs per prescription was calculated. RESULTS: 1238 patients attended the orthopaedics OPD during the study period. 186 prescriptions were randomly selected for analysis. The mean number of drugs per prescription was 1.9. Low backache was the most common reason for attending the OPD. Nonsteroidal anti-inflammatory drugs (NSAIDs) were the most commonly prescribed drug group. Diclofenac and meloxicam were the most commonly prescribed drugs. Mean cost of drugs was 166.2 Nepalese rupees. Injections and antibiotics were prescribed in 16 (8.6%) and 7 (3.8%) encounters respectively. 51 prescriptions (27.4%) had various problems. Absence of diagnosis on the prescriptions and the duration of treatment were most commonly observed. CONCLUSIONS: Percentage of prescribing by generic name was low. Educational sessions for the doctors at different levels to encourage prescribing by generic names and on correct writing of prescriptions may be considered. Studies covering a larger number of patients and for a longer time period are required. A greater number of patients can be studied, seasonal variations can be overcome and drug utilization can be measured quantitatively.Item Prevalence of pneumococcal serotypes in invasive diseases in southern India.(1996-09-01) John, T J; Pai, R; Lalitha, M K; Jesudason, M V; Brahmadathan, K N; Sridharan, G; Steinhoff, M CForty two pneumococcal strains obtained in Vellore, Tamil Nadu, from 42 patients with invasive diseases, namely pneumonia, meningitis, or peritonitis were typed. Over one-third of pneumococci in children and nearly half in adults were serotype followed by serogroups/types 5, 6 and 7 which were most common in children and adults taken together. These 4 serogroups/types accounted for 11 (79%) of 14 strains in children and 20 (71%) of 28 strains in adults. The remaining 11 strains belonged to 8 serogroups/types, namely 3, 4, 10, 11, 12, 13, 19 and 20.Item Rapid assay for detection of chloramphenicol acetyl transferase in Haemophilus influenzae.(2001-08-12) Satish, N; Manoharan, A; Pai, R; Lalitha, M KBACKGROUND & OBJECTIVES: Haemophilus influenzae causes a variety of life threatening infections in humans. Early detection of antimicrobial resistance is of importance in the treatment and management of infection. The modified Slack's method, a simple assay, has been evaluated in this study for the early detection of chloramphenicol resistance. METHODS: Fifty isolates of H. influenzae from invasive and non-invasive sites were included. Antimicrobial susceptibility testing was done by disc diffusion method and minimum inhibitory concentration (MIC) determination was performed for chloramphenicol only. Modified Slack's method was used to test for the production of chloramphenicol acetyl transferase (CAT). RESULTS: Invasive isolates showed higher degree of resistance to chloramphenicol (72%) compared to non-invasive ones (28%). One hundred per cent association was found between results of disc diffusion, MIC and CAT production amongst strains resistant to chloramphenicol. INTERPRETATION & CONCLUSION: The findings suggested that chloramphenicol still remains the drug of choice for treatment for non-invasive infection caused by H. influenzae. Modified Slack's method is a simple, rapid, inexpensive and reliable method for the detection of chloramphenicol resistance amongst H. influenzae.Item Relation of mast cell, nerve and fibrosis in appendix.(1998-01-15) Naik, R; Pai, M R; Bansal, R; Pai, RThe relationship of mast cells, nerves and fibrosis was studied in 50 cases of Appendix using simple histochemical technique. In the mucosa, the mast cell number was greater in the early stages of fibrosis. Both in the mucosa and submucosa mast cells were found closely associated with neural tissue. As the fibrosis increased this association between mast cells and neural tissue was retained only in the submucosa.Item Renin profile in primary hypertension.(1987-06-01) Hegde, B M; Pai, R; Kamath, B R; Bhat, E KItem Secondary extramedullary plasmacytoma of the breast: diagnosed by fine needle aspiration cytology.(2007-10-08) Pai, R; Kini, H; Ghartimagar, DA 34years old female who was a known case of multiple myeloma presented with a mass in the right breast. Clinically a differential diagnosis of breast carcinoma or secondary involvement by multiple myeloma was considered. Fine Needle Aspiration Cytology (FNAC) of the mass was performed which showed dispersed population of plasma cells with eccentrically placed nuclei, abundant cytoplasm and the characteristic paranuclear hof.Item Systemic bacterial infections in bone marrow transplant patients.(2000-03-23) Lalitha, M K; Pai, R; Manoharan, A; Jesudason, M V; Brahmadathan, K N; Srivastava, A; Chandy, MThe clinical microbiology department at CMC&H, Vellore in conjunction with the haematology department carries out routine surveillance of patients admitted to the hematology department. Since 1994 in a sample population of 55 patients with various underlying clinical conditions who have had bone marrow transplant, sepsis was observed in 16 patients (29%). The predominant Gram negatives associated with sepsis were non-fermenting Gram negative bacilli and all the 5 Gram positives were coagulase negative staphylococci. These organisms were susceptible to most of the routinely used antimicrobial agents. Continued surveillance is needed to determine changing trends with respect to organisms causing systemic infections and their susceptibility to antimicrobials.Item Tricky typhus ticks two: A report of two sisters from North India presenting with acute respiratory distress syndrome due to scrub typhus.(2016-04) Pai, R; Chaudhry, R; Gupta, N; Sryma, P B; Biswas, A; Dey, A BScrub typhus is emerging as an important cause of acute febrile illness in Northern India. This is a report of two sisters presenting concurrently with acute respiratory distress syndrome. A diagnosis of scrub typhus was made in both the patients, and they were successfully treated with doxycycline.