Browsing by Author "Wali, J P"
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Item Adult thoracic ganglioneuroblastoma with massive pleural effusion.(1993-05-01) Aggarwal, P; Wali, J P; Singh, MItem Albright's hereditary osteodystrophy with hypoparathyroidism.(1996-02-01) Handa, R; Wali, J P; Singh, R I; Modi, G; Chirukpalli, R; Ahluwalia, G; Sood, R; Meena, H SItem Awareness of brain death and organ transplantation among high school children.(1999-03-08) Wig, N; Aggarwal, P; Kailash, S; Handa, R; Wali, J PThe objective of this study was to assess the awareness of the concepts of brain death and organ transplantation among high school children. One hundred and eighty eight students of class 12th of a reputed public school were studied. Structured questionnaires were used to assess their knowledge in various aspects of brain death and organ transplantation. Following the questionnaire, they were provided with educational information on brain death and organ transplantation. This was followed by similar questionnaires to assess any change in awareness of brain death and organ transplantation. Results spoke of widespread awareness and acceptance of organ transplantation in the high school children. However, the awareness of various aspects of brain death was quite low. There was significant increase in awareness and acceptance of brain death after educating the students. Education about various aspects of brain death, its immense importance for organ donation and legality of brain death needs to be highlighted.Item Awareness of brain death and organ transplantation among office-goers in New Delhi.(1997-11-03) Wig, N; Aggarwal, P; Kailash, S; Handa, R; Wali, J PItem Bleomycin-induced scleroderma.(2004-01-07) Sharma, Shefali K; Handa, R; Sood, Rita; Aggarwal, P; Biswas, A; Kumar, Uma; Wali, J PSystemic sclerosis is a connective tissue disease, which can be triggered by environmental factors. We report one such case of bleomycin-induced scleroderma.Item Blood fibrinolytic activity in pulmonary tuberculosis.(1967-04-01) Laha, P N; Wali, J PItem Brain death and organ donation.(1997-05-01) Wig, N; Wadhwa, J; Aggarwal, P; Handa, R; Wali, J PBrain death is the irreversible cessation of all brain functions. Brainstem death is the 'physiological core' of brain death. The Indian Parliament has given legal recognition to brain death though it applies only in the context of performance of organ transplantation. Brain death is diagnosed if there is irreversible loss of consciousness, absence of brainstem reflexes and apnoea. Care and diligence in the application of the criteria for brain death provide important safeguards for Individual patients and the community in general. These criteria also allow death to be diagnosed with certainty prior to the occurrence of circulatory arrest. Solid organ transplantation has become possible through the diagnosis of brain death but is not the primary consideration; the management of a potential organ donor, who is brain dead, is also vital. If optimal preservation of organs for transplantation is to be achieved the clinician needs to understand the pathophysiology and consequences of changes occurring in various organs after brain death and active management is required to reverse or control these changes. Discussions about organ donation with relatives of brain deed patients are never easy. These should always be frank and sympathetic. It has been suggested that those whose interests lie in transplantation must bear the responsibility of educating the general public. This will help intensivists who expose themselves knowingly to the unpleasant aspects of organ donation.Item Brucellosis in north India: results of a prospective study.(1998-06-23) Handa, R; Singh, S; Singh, N; Wali, J PHuman brucellosis is a significant public health problem in India, the magnitude of which is not known. Paucity of clinico-epidemiologic data hampers control strategies. We prospectively studied 121 cases of fever of unknown origin (FUO) and 50 occupationally exposed individuals. Four patients with FUO had acute brucellosis (3.3%) while 8 (6.6%) had serological evidence of previous brucella infection. Seven of the 50 (14%) asymptomatic, 'at risk' individuals screened were seropositive for brucella. Persistence of the animal reservoir of infection, low physician awareness, poor availability of diagnostic facilities, and the non existence of regional data bases contribute towards the perpetuation of this zoonosis in India, while it has been eradicated from most developed countries.Item Classical polyarteritis nodosa and microscopic polyangiitis--a clinicopathologic study.(2001-03-09) Handa, R; Wali, J P; Gupta, S D; Dinda, A K; Aggarwal, P; Wig, N; Biswas, AOBJECTIVE: To describe the clinical spectrum, laboratory features, histopathological findings and treatment outcome in patients with classical polyarteritis nodosa (PAN) and microscopic polyangiitis (MPA). MATERIAL AND METHODS: Patients with PAN and MPA seen at a large teaching hospital in north India over a period of five years (1994-99) were included in the present study. RESULTS: We encountered five patients with PAN and six patients with MPA during the study period. Of the five patients with PAN, two had systemic disease while three had limited PAN. The patients with limited PAN included two with cutaneous PAN and one with PAN confined to the nerves. Constitutional symptoms, musculoskeletal complaints, peripheral neuropathy and skin lesions dominated the clinical picture. Fifty percent of the MPA patients presented as pulmonary renal syndrome. All the patients with PAN were HBsAg and ANCA negative and had normal urinalysis findings. In contrast, all patients with MPA demonstrated an active urine sediment and 83.3% were pANCA positive. Some of the rare features encountered by us were the presence of antiphospholipid syndrome and extensive interstitial lung disease in MPA, and spontaneous recovery in one patient with systemic PAN. Treatment outcome was better in PAN as compared with MPA. CONCLUSIONS: The clinical spectrum of PAN and MPA is quite varied. A good outcome is possible with the use of corticosteroids and cyclophosphamide.Item A clinico-bacteriological study of peripheral tuberculous lymphadenitis.(2001-08-12) Aggarwal, P; Wali, J P; Singh, S; Handa, R; Wig, N; Biswas, AOBJECTIVE: Tuberculous lymphadenitis is the commonest form of extra-pulmonary tuberculosis. It is most often caused by M. tuberculosis though several reports from other countries have shown mycobacteria other than tuberculosis (MOTT) to be responsible for a significant proportion of tuberculous lymphadenitis cases. The present study was conducted to find the prevalence of M. tuberculosis and MOTT as aetiological agents in patients with peripheral tuberculous lymphadenitis. METHODS: A total of 138 patients with tuberculous lymphadenitis were included in the study. Diagnosis of tuberculosis was established on the basis of fine needle aspiration cytology, histopathology, presence of mycobacteria on Ziehl Neelson stain or auramine rhodamine stain, or aspiration of pus with negative Gram's stain and pyogenic cultute with radiologic evidence of pulmonary tuberculosis. Mycobacterial cultures were performed on aspirated material and species identified using standard methods. RESULTS: Of 138 patients, single lymph nodal enlargement was found in 48.6% patients while others had more than one lymph nodes. Lymph nodes were matted in 26.8% cases while fluctuation could be elicited in 12.3% patients. Chest X-ray showed evidence of active pulmonary lesions or mediastinal lymphadenopathy in 28.3% cases. The fine needle aspiration cytology was positive for tuberculous lymphadenitis in 41.3% cases while it revealed granulomas or necrosis in another 13% cases. The Ziehl-Neelson and the auramine-rhodamine staining were positive in 19.6% and 26.8% patients, respectively. On culture, the lymph node aspirate was positive for Mycobacterium species in 40.6% patients. In all but two cases, the culture revealed presence of Mycobacterium tuberculosis. The other two cultures revealed growth of Mycobacterium fortuitum chelonae complex. Of the two HIV-positive patients, M. tuberculosis could be isolated in one case. CONCLUSION: Findings of this study suggest that M. tuberculosis is still the most common cause of tuberculous lymphadenitis and MOTT are responsible for very few cases. However, such studies need to be carried out frequently at various centres so as to see any periodic and geographic variations within India.Item Dengue virus infection during post-epidemic period in Delhi, India.(1999-09-25) Vajpayee, M; Mohankumar, K; Wali, J P; Dar, L; Seth, P; Broor, SDengue fever (DF) and dengue hemorrhagic fever (DHF) are major public health problems in India. During the period following an epidemic, a study was carried out using virological and serological tests for confirmation of suspected cases of dengue virus infection in fever cases presenting to the All India Institute of Medical Sciences. Serum samples of suspected DF/DHF cases were processed from January to December 1997. In 37 samples from patients with fever of less than 5-day duration, received on ice, virus isolation was attempted in C6/36 clone of Aedes albopictus cell line, followed by indirect fluorescent antibody staining with monoclonal antibodies to dengue viruses 1 to 4. One hundred and forty-three serum samples from patients with more than 5 days fever were tested for dengue specific IgM antibody by either MAC-ELISA or a rapid immunochromatographic assay. Dengue virus type 1 was demonstrated by culture in 8 (21.6%) of 37 serum samples and IgM antibody could be detected in 42 (29.4%) of the 143 serum samples by the serological methods. The peak of dengue virus infection was seen from September to November 1997.Item Disseminated cryptococcosis.(1996-05-01) Handa, R; Banerjee, U; Gupta, K; Singh, M K; Singh, H; Wali, J PItem Doxycycline in the treatment of rheumatoid arthritis--a pilot study.(2000-08-29) Sreekanth, V R; Handa, R; Wali, J P; Aggarwal, P; Dwivedi, S NOBJECTIVE: To assess the efficacy and safety of doxycycline as a disease modifying anti-rheumatic drug (DMARD) in rheumatoid arthritis (RA) and compare it with methotrexate, a standard DMARD. MATERIAL AND METHODS: A single (assessor) blind prospective study with 15 patients of RA randomized to doxycycline and 14 to methotrexate. Baseline disease characteristics were similar in both groups. RESULTS: All disease activity measures studied viz. tender and swollen joint counts, physician and patient global assessment, visual analogue pain scale, health assessment questionnaire and ESR improved in both the treatment groups after six months of treatment. The difference between doxycycline and methotrexate was not statistically significant. No major side effects necessitating drug withdrawal were reported from either group. The side effects were few and mostly gastrointestinal. CONCLUSION: Doxycycline is a safe disease modifying drug in RA whose effect is sustained at six months. It compared favourably with methotrexate over a six month follow up.Item Efficacy of sodium antimony gluconate and ketoconazole in the treatment of kala-azar--a comparative study.(1997-06-01) Wali, J P; Aggarwal, P; Nandy, A; Singh, S; Addy, M; Guha, S K; Dwivedi, S N; Karmarkar, M G; Maji, A KThe present study was undertaken to determine the efficacy of ketoconazole in comparison to sodium antimony gluconate (SAG) in the treatment of kala-azar. The study was conducted at two centres: All India Institute of Medical Science, New Delhi and Calcutta School of Tropical Medicine, Calcutta. A total of 180 patients with proven kala-azar were recruited. After preliminary investigations, the patients were randomly divided into 2 groups: One group received ketoconazole in a dose of 600 mg/ day in 3 divided doses for 4 weeks while the other group was treated with SAG at a dose of 20 mg/kg/day up to a maximum of 850 mg/day for 4 weeks. The patients were followed up by clinical examination, liver functions, haemogram and the bone marrow/splenic aspiration. Responders were followed up at 3 and 9 months of intervals. Of 90 cases in SAG, 78 (81.7%) got cured initially while under ketoconazole group, only 26 (33.3%) of 78 patients responded initially (p < 0.001). After 3 months of follow up, 75 of 78 SAG-responders (96.2%) and 24 of 26 ketoconazole-responders (92.3%) continued to be in remission. Despite the fact that 2 patients in each group were lost to follow up at 9 months, similar observations were noted with only one relapse in SAG group. The response to SAG was comparable at the two centres. However, the response to ketoconazole was better at Delhi centre as compared to that at Calcutta. There were no significant side effects or hormonal changes in any of the patients in ketoconazole group at Delhi centre. Significantly higher side effects were reported at Calcutta centre in ketoconazole group (P < 0.05). No satisfactory explanation can be given for this difference in response to ketoconazole at two centres. However, it is known that leishmanial parasites of different geographical origin differ in their response to different drugs and this could be one of the reasons for difference observed in response rate to ketoconazole as the study involved different populations of people.Item Estimation & significance of serum & synovial fluid malondialdehyde levels in rheumatoid arthritis.(1999-05-22) Chaturvedi, V; Handa, R; Rao, D N; Wali, J PSerum and synovial fluid (SF) levels of malondialdehyde (MDA), a marker of free radical induced lipid peroxidation, were estimated in patients of rheumatoid arthritis (RA) and compared with healthy controls and patients of osteoarthritis (OA). While serum MDA levels were similar in healthy controls (0.24 +/- 0.10 nmol/ml) and OA (0.28 +/- 0.11 nmol/ml), the serum levels in RA (0.47 +/- 0.19 nmol/ml) were significantly higher as compared to both healthy controls and OA patients; and correlated with synovial fluid (SF) MDA levels. No difference was observed in SF-MDA levels in RA (0.17 +/- 0.07 nmol/ml) and OA (0.16 +/- 0.09). MDA levels did not correlate with markers of disease activity in RA like joint counts, duration of morning stiffness, erythrocyte sedimentation rate etc. Increased serum MDA levels in RA suggest the role of free radicals in the pathogenesis of this inflammatory arthropathy and support the need for further studies assessing the therapeutic role of free radical scavengers in RA.Item Flumazenil in acute benzodiazepine overdose.(2002-08-08) Mohan, A; Mohan, C; Aggarwal, P; Handa, R; Wali, J PItem Giant cell arteritis--a rare cause of fever of unknown origin in India.(2002-06-21) Sood, Rita; Zulfi, H; Ray, R; Handa, R; Wali, J PGiant cell arteritis (GCA) is a systemic large vessel vasculitis. Awareness of various manifestations of GCA is essential for early recognition and prompt treatment so as to prevent complications like blindness. GCA is one of the relatively common causes of fever of unknown origin (FUO) in the elderly in USA and Europe. However, no such cases have been reported from India. A case of GCA presenting as FUO is reported and the literature reviewed.Item Hairy cell leukaemia with possible pulmonary and renal involvement.(1986-10-01) Sharma, S K; Wali, J P; Pati, H; Pande, J N; Guleria, J SItem Halofantrine in G-6 PD deficiency.(1997-11-07) Handa, R; Wig, N; Aggarwal, P; Suresh, V; Biswas, A; Wali, J PItem Indian childhood cirrhosis and kala-azar in a child.(1990-04-01) Aggarwal, P; Wali, J P; Arora, N K; Chopra, P
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