Introduction: Gaucher’s disease is a congenital lysosomal storage disorder caused by an autosomal... more Introduction: Gaucher’s disease is a congenital lysosomal storage disorder caused by an autosomal recessive mutation in B-glucocerebrosidase. It is a multi-system disease, wherein patients present with hematological abnormalities, joint pain, osteonecrosis, and developmental delay. We present a case of 38-year-old male with a painless solitary soft-tissue swelling over the left proximal tibia, eventually diagnosed it to be a case of Gaucher’s disease. This case is unique in the literature, because this subcutaneous Gaucher mass was not associated with a significant past history and was being evaluated as a standard approach to a bone tumor. Case Presentation: A 38-year-old man presented to our outpatient department with a solitary, painless soft-tissue swelling of the left proximal tibia noticed 6 months back, which has gradually progressed to a present size of 9x5 cm over a period of 6 months. General physical examination revealed moderate splenomegaly. Radiographs showed an osteolytic lesion in the left proximal tibia without cortical erosion. Radiographs for skeletal survey revealed similar osteolytic lesions elsewhere. Hematological investigations revealed thrombocytopenia. A serum protein electrophoresis was found to be normal and the urine was negative for myeloma proteins. Blood workup for endocrine abnormalities was within normal limits. MRI of the lesion suggests bone infarct. Biopsy from the lesion showed a giant binucleate storage cell filled with glucocerebrosides suggestive of Gaucher’s disease. The diagnosis was confirmed by elevated plasma levels of glucocerebrosidases. Conclusion: Gaucher’s disease is a rare metabolic disease of the bone which may mimic a primary bone tumor or metastasis. A step-wise meticulous approach with biopsy and elevated plasma levels of glucocerebrosidase helps establish the diagnosis. Once must have a high index of suspicion for Gaucher’s disease in an adult with multiple osteolytic lesions without any significant past medical and surgical history.
In last few years, average life expectancy of humans has increased globally. Exposure to hazardou... more In last few years, average life expectancy of humans has increased globally. Exposure to hazardous chemicals, ultraviolet (UV) radiation and other carcinogens has also increased the cancer burden in humans. Skin cancer is mainly associated with the DNA damage because of the prolonged exposure to UV radiation. Several structural changes, mutations and amplifications of oncogenes have been reported in skin cancer. The continuous development of bioinformatics approaches, next-generation sequencing, proteomics, transcripts, and epigenetic analysis has increased the understanding of cancer progression and molecular mechanisms and to design appropriate drug for the diseases. In this chapter, we have discussed the importance of bioinformatics in understanding the molecular mechanisms of skin cancer progression, related signaling pathways, data analysis, and drug development.
Background Coronary artery bypass graft surgery (CABG) is one of the principle therapies for coro... more Background Coronary artery bypass graft surgery (CABG) is one of the principle therapies for coronary artery disease, as it improves survival rate and quality of life (QoL). Polypropylene suture is commonly used in vascular and cardiac surgeries for anastomosis due to its long-term tensile strength and minimal tissue trauma. This study compared the clinical equivalence of Trulene® (Healthium Medtech Limited) and Prolene® (Ethicon-Johnson & Johnson) polypropylene sutures regarding incidence of myocardial infarction, stroke, renal failure and cardiac death (MACCE) occurring up to 26 weeks’ period post-CABG surgery. Methods This multicenter, prospective, two-arm, parallel-group, randomized (1:1), single-blind study (n = 89) was conducted between August 2020 and September 2021. The primary endpoint, post-surgery cumulative incidence of MACCE was evaluated. In addition, anastomotic revision, surgical site infection (SSI), operative time, length of post-operative hospital stay, repeat rev...
Introduction: Gaucher’s disease is a congenital lysosomal storage disorder caused by an autosomal... more Introduction: Gaucher’s disease is a congenital lysosomal storage disorder caused by an autosomal recessive mutation in B-glucocerebrosidase. It is a multi-system disease, wherein patients present with hematological abnormalities, joint pain, osteonecrosis, and developmental delay. We present a case of 38-year-old male with a painless solitary soft-tissue swelling over the left proximal tibia, eventually diagnosed it to be a case of Gaucher’s disease. This case is unique in the literature, because this subcutaneous Gaucher mass was not associated with a significant past history and was being evaluated as a standard approach to a bone tumor. Case Presentation: A 38-year-old man presented to our outpatient department with a solitary, painless soft-tissue swelling of the left proximal tibia noticed 6 months back, which has gradually progressed to a present size of 9x5 cm over a period of 6 months. General physical examination revealed moderate splenomegaly. Radiographs showed an osteol...
The adaptation of advanced technologies in the medical sector has tremendously enhanced the surgi... more The adaptation of advanced technologies in the medical sector has tremendously enhanced the surgical and treatment procedures. Advance manufacturing technology like 3D printing is influencing the pre-operative surgical planning procedures. Moreover, the technology is being used to print complex anatomical models for medical training purposes. Surgical assistive devices and medical equipment are also being fabricated using this technology. However, the adaptation of this technology by the healthcare sector in developing countries is still a challenge. Partially due to lack of awareness regarding the potential of the technology and partially due to the increased surgical cost associated with it. Therefore, it is crucial to demonstrate the prospects of this technology in the biomedical area. In this regard, an attempt has been made to exhibit the application of 3D printing technology in the area of surgical planning, medical training, and customized surgical devices. The present paper outlines the process flow for 3D printing of biomedical models from medical images. Moreover, the paper also presents the case studies for the utilization of 3D printing technology in pre-operative surgical planning of tibial plateau fracture, fabrication of artificial temporal bone for mock surgery and educational purpose, and for the fabrication of the orthodontic drill guides.
In last few years, average life expectancy of humans has increased globally. Exposure to hazardou... more In last few years, average life expectancy of humans has increased globally. Exposure to hazardous chemicals, ultraviolet (UV) radiation and other carcinogens has also increased the cancer burden in humans. Skin cancer is mainly associated with the DNA damage because of the prolonged exposure to UV radiation. Several structural changes, mutations and amplifications of oncogenes have been reported in skin cancer. The continuous development of bioinformatics approaches, next-generation sequencing, proteomics, transcripts, and epigenetic analysis has increased the understanding of cancer progression and molecular mechanisms and to design appropriate drug for the diseases. In this chapter, we have discussed the importance of bioinformatics in understanding the molecular mechanisms of skin cancer progression, related signaling pathways, data analysis, and drug development.
Homograft cardiac valves have been shown to have several advantages over conventional prosthetic ... more Homograft cardiac valves have been shown to have several advantages over conventional prosthetic valves. From October 1993 through November 1996, 273 homografts (262 valved and 11 non-valved) were used in various procedures at the All India Institute of Medical Sciences, New Delhi, India. The recommendations of the American Association of Tissue Banks were followed for procurement, harvesting, and storage of the valves. One hundred and ninety-six hearts were procured yielding a total of 439 homograft valves; 192 were pulmonary homografts, 187 were aortic homografts, and 60 were mitral homografts. Eighty-five homografts were used in the Ross procedure, 64 were used in homograft replacement of the aortic valve, 28 were used in replacement of the mitral valve, 85 were used in various operations for heart disease as valved conduits, and 11 homografts were used as either non-valved conduits or for patch repair. One hundred and thirty-five homografts (31%) were discarded for various reaso...
The bidirectional Glenn Shunt has been advocated for definitive or staged palliation of patients ... more The bidirectional Glenn Shunt has been advocated for definitive or staged palliation of patients with a functional single ventricle and decreased pulmonary blood flow who are unsuitable for a Fontan operation. Between April 1990 and July 1994, 86 patients underwent bidirectional Glenn operation at the All India Institute of Medical Sciences in New Delhi. This operation was performed electively in 73 patients (group I), as a take-down for Fontan failure in 10 patients (group II), and to complement a two-ventricle repair in 3 patients in whom the right ventricle or the tricuspid valve was inadequate to handle the entire systemic venous return (group III). Fifty-five other procedures were performed in addition to the cavopulmonary shunt. The mean ICU stay was 2 days. There were 5 early deaths in group I, 6 in group II, and none in group III. Mean oxygen saturation at the time of discharge was 84.2% on room air. Follow-up ranged from 3 to 51 months. The bidirectional Glenn shunt was def...
Present study was conducted to study the morphometric characteristics of slaughtered Murrah buffa... more Present study was conducted to study the morphometric characteristics of slaughtered Murrah buffalo bull testis and its correlation with seminal attributes of epididymal semen. Total 56 pair of slaughtered Murrah buffalo bull testicles were procured from Allana, slaughterhouse, Arrora, and Mass agro food Pvt. Ltd. Unnao Uttar Pradesh, India; maintained at Deep Frozen Semen Laboratory, College of Veterinary science, and animal Husbadry, Ayodhya, Uttar Pradesh, India. Various morphometric parameters of testes and epididymis were analyzed and their correlations with attributes of epididymal semen were evaluated. No significance difference in seminal attributes between 6 h and 12 h after collection of testicles is clearly indicated that semen can be collect up to 12 h after death of animal without any significance loss in quality of semen in Murrah buffalo bull. Significant strong positive correlation among important characteristics (motility, livability and HOS positive sperm) suggests...
A pluriparus full-term exhausted murrah buffalo aged about 8 years, in its 3rd parity escorted to... more A pluriparus full-term exhausted murrah buffalo aged about 8 years, in its 3rd parity escorted to the TVCC, College of Veterinary Science and Animal Husbandry, ANDUAT, Ayodhya, India, with history of straining since last 12 h. On per vaginum examination, this case was diagnosed as dystocia because of true Schistosoma reflexus. A successful per-vaginal management of dystocia due to Schistosomus reflexus monster by traction and mutation is performed.
Background: Anoestrus is still one of the most prevalent reproductive disorders in dairy cows des... more Background: Anoestrus is still one of the most prevalent reproductive disorders in dairy cows despite technological advances in animal husbandry. Evaluation of blood biochemical profile is of diagnostic value to determine disease or health status of animal. The current study was aimed to evaluate the effect of different therapeutic regimen on blood biochemical profile, oestrus induction response and conception rate of anoestrus cows.Methods: Thirty two postpartum anoestrus cows randomly allocated to four groups as G0 (negative control), GI, GII, GIII, GIV and 8 normal cyclic as GV (positive control). Dewormer and mineral mixture administered to GI, GII, GIII, GIV while group GII, GIII and GIV additionally received janova, sepia and Ovsynch protocol respectively.Result: Different therapeutic protocols have variable effects on blood biochemical parameters. Overall oestrus induction response in G0, GI, GII, GIII, GIV and GV is 0.00, 50, 62.5, 75, 87.5 and 100.00 per cent respectively w...
A total of 100 patients of tetralogy of Fallot aged 13 years and over were operated upon at the A... more A total of 100 patients of tetralogy of Fallot aged 13 years and over were operated upon at the All India Institute of Medical Sciences, New Delhi, India between January 1991 and December 1996. There were 69 males (69%) and 31 females (31%). Age ranged from 13 years to 43 years (mean 19.66 years). Twenty % of patients had preoperative complications like haemoptysis, cerebrovascular accidents, brain abscess and infective endocarditis. Twenty-two patients had previous palliative shunts. Fifteen patients had coil embolisation of major collaterals prior to surgery. In hospital mortality rate was 4%. Follow-up ranged from 1 month to 5 years (mean 3.4 years). There was one late death due to infective endocarditis. Postoperatively 93.6% patients were in NYHA class I. Significant residual defects warranting re-operation were present in three patients. Total correction of tetralogy of Fallot in older patients can be performed with acceptable results.
Introduction: Gaucher’s disease is a congenital lysosomal storage disorder caused by an autosomal... more Introduction: Gaucher’s disease is a congenital lysosomal storage disorder caused by an autosomal recessive mutation in B-glucocerebrosidase. It is a multi-system disease, wherein patients present with hematological abnormalities, joint pain, osteonecrosis, and developmental delay. We present a case of 38-year-old male with a painless solitary soft-tissue swelling over the left proximal tibia, eventually diagnosed it to be a case of Gaucher’s disease. This case is unique in the literature, because this subcutaneous Gaucher mass was not associated with a significant past history and was being evaluated as a standard approach to a bone tumor. Case Presentation: A 38-year-old man presented to our outpatient department with a solitary, painless soft-tissue swelling of the left proximal tibia noticed 6 months back, which has gradually progressed to a present size of 9x5 cm over a period of 6 months. General physical examination revealed moderate splenomegaly. Radiographs showed an osteolytic lesion in the left proximal tibia without cortical erosion. Radiographs for skeletal survey revealed similar osteolytic lesions elsewhere. Hematological investigations revealed thrombocytopenia. A serum protein electrophoresis was found to be normal and the urine was negative for myeloma proteins. Blood workup for endocrine abnormalities was within normal limits. MRI of the lesion suggests bone infarct. Biopsy from the lesion showed a giant binucleate storage cell filled with glucocerebrosides suggestive of Gaucher’s disease. The diagnosis was confirmed by elevated plasma levels of glucocerebrosidases. Conclusion: Gaucher’s disease is a rare metabolic disease of the bone which may mimic a primary bone tumor or metastasis. A step-wise meticulous approach with biopsy and elevated plasma levels of glucocerebrosidase helps establish the diagnosis. Once must have a high index of suspicion for Gaucher’s disease in an adult with multiple osteolytic lesions without any significant past medical and surgical history.
In last few years, average life expectancy of humans has increased globally. Exposure to hazardou... more In last few years, average life expectancy of humans has increased globally. Exposure to hazardous chemicals, ultraviolet (UV) radiation and other carcinogens has also increased the cancer burden in humans. Skin cancer is mainly associated with the DNA damage because of the prolonged exposure to UV radiation. Several structural changes, mutations and amplifications of oncogenes have been reported in skin cancer. The continuous development of bioinformatics approaches, next-generation sequencing, proteomics, transcripts, and epigenetic analysis has increased the understanding of cancer progression and molecular mechanisms and to design appropriate drug for the diseases. In this chapter, we have discussed the importance of bioinformatics in understanding the molecular mechanisms of skin cancer progression, related signaling pathways, data analysis, and drug development.
Background Coronary artery bypass graft surgery (CABG) is one of the principle therapies for coro... more Background Coronary artery bypass graft surgery (CABG) is one of the principle therapies for coronary artery disease, as it improves survival rate and quality of life (QoL). Polypropylene suture is commonly used in vascular and cardiac surgeries for anastomosis due to its long-term tensile strength and minimal tissue trauma. This study compared the clinical equivalence of Trulene® (Healthium Medtech Limited) and Prolene® (Ethicon-Johnson & Johnson) polypropylene sutures regarding incidence of myocardial infarction, stroke, renal failure and cardiac death (MACCE) occurring up to 26 weeks’ period post-CABG surgery. Methods This multicenter, prospective, two-arm, parallel-group, randomized (1:1), single-blind study (n = 89) was conducted between August 2020 and September 2021. The primary endpoint, post-surgery cumulative incidence of MACCE was evaluated. In addition, anastomotic revision, surgical site infection (SSI), operative time, length of post-operative hospital stay, repeat rev...
Introduction: Gaucher’s disease is a congenital lysosomal storage disorder caused by an autosomal... more Introduction: Gaucher’s disease is a congenital lysosomal storage disorder caused by an autosomal recessive mutation in B-glucocerebrosidase. It is a multi-system disease, wherein patients present with hematological abnormalities, joint pain, osteonecrosis, and developmental delay. We present a case of 38-year-old male with a painless solitary soft-tissue swelling over the left proximal tibia, eventually diagnosed it to be a case of Gaucher’s disease. This case is unique in the literature, because this subcutaneous Gaucher mass was not associated with a significant past history and was being evaluated as a standard approach to a bone tumor. Case Presentation: A 38-year-old man presented to our outpatient department with a solitary, painless soft-tissue swelling of the left proximal tibia noticed 6 months back, which has gradually progressed to a present size of 9x5 cm over a period of 6 months. General physical examination revealed moderate splenomegaly. Radiographs showed an osteol...
The adaptation of advanced technologies in the medical sector has tremendously enhanced the surgi... more The adaptation of advanced technologies in the medical sector has tremendously enhanced the surgical and treatment procedures. Advance manufacturing technology like 3D printing is influencing the pre-operative surgical planning procedures. Moreover, the technology is being used to print complex anatomical models for medical training purposes. Surgical assistive devices and medical equipment are also being fabricated using this technology. However, the adaptation of this technology by the healthcare sector in developing countries is still a challenge. Partially due to lack of awareness regarding the potential of the technology and partially due to the increased surgical cost associated with it. Therefore, it is crucial to demonstrate the prospects of this technology in the biomedical area. In this regard, an attempt has been made to exhibit the application of 3D printing technology in the area of surgical planning, medical training, and customized surgical devices. The present paper outlines the process flow for 3D printing of biomedical models from medical images. Moreover, the paper also presents the case studies for the utilization of 3D printing technology in pre-operative surgical planning of tibial plateau fracture, fabrication of artificial temporal bone for mock surgery and educational purpose, and for the fabrication of the orthodontic drill guides.
In last few years, average life expectancy of humans has increased globally. Exposure to hazardou... more In last few years, average life expectancy of humans has increased globally. Exposure to hazardous chemicals, ultraviolet (UV) radiation and other carcinogens has also increased the cancer burden in humans. Skin cancer is mainly associated with the DNA damage because of the prolonged exposure to UV radiation. Several structural changes, mutations and amplifications of oncogenes have been reported in skin cancer. The continuous development of bioinformatics approaches, next-generation sequencing, proteomics, transcripts, and epigenetic analysis has increased the understanding of cancer progression and molecular mechanisms and to design appropriate drug for the diseases. In this chapter, we have discussed the importance of bioinformatics in understanding the molecular mechanisms of skin cancer progression, related signaling pathways, data analysis, and drug development.
Homograft cardiac valves have been shown to have several advantages over conventional prosthetic ... more Homograft cardiac valves have been shown to have several advantages over conventional prosthetic valves. From October 1993 through November 1996, 273 homografts (262 valved and 11 non-valved) were used in various procedures at the All India Institute of Medical Sciences, New Delhi, India. The recommendations of the American Association of Tissue Banks were followed for procurement, harvesting, and storage of the valves. One hundred and ninety-six hearts were procured yielding a total of 439 homograft valves; 192 were pulmonary homografts, 187 were aortic homografts, and 60 were mitral homografts. Eighty-five homografts were used in the Ross procedure, 64 were used in homograft replacement of the aortic valve, 28 were used in replacement of the mitral valve, 85 were used in various operations for heart disease as valved conduits, and 11 homografts were used as either non-valved conduits or for patch repair. One hundred and thirty-five homografts (31%) were discarded for various reaso...
The bidirectional Glenn Shunt has been advocated for definitive or staged palliation of patients ... more The bidirectional Glenn Shunt has been advocated for definitive or staged palliation of patients with a functional single ventricle and decreased pulmonary blood flow who are unsuitable for a Fontan operation. Between April 1990 and July 1994, 86 patients underwent bidirectional Glenn operation at the All India Institute of Medical Sciences in New Delhi. This operation was performed electively in 73 patients (group I), as a take-down for Fontan failure in 10 patients (group II), and to complement a two-ventricle repair in 3 patients in whom the right ventricle or the tricuspid valve was inadequate to handle the entire systemic venous return (group III). Fifty-five other procedures were performed in addition to the cavopulmonary shunt. The mean ICU stay was 2 days. There were 5 early deaths in group I, 6 in group II, and none in group III. Mean oxygen saturation at the time of discharge was 84.2% on room air. Follow-up ranged from 3 to 51 months. The bidirectional Glenn shunt was def...
Present study was conducted to study the morphometric characteristics of slaughtered Murrah buffa... more Present study was conducted to study the morphometric characteristics of slaughtered Murrah buffalo bull testis and its correlation with seminal attributes of epididymal semen. Total 56 pair of slaughtered Murrah buffalo bull testicles were procured from Allana, slaughterhouse, Arrora, and Mass agro food Pvt. Ltd. Unnao Uttar Pradesh, India; maintained at Deep Frozen Semen Laboratory, College of Veterinary science, and animal Husbadry, Ayodhya, Uttar Pradesh, India. Various morphometric parameters of testes and epididymis were analyzed and their correlations with attributes of epididymal semen were evaluated. No significance difference in seminal attributes between 6 h and 12 h after collection of testicles is clearly indicated that semen can be collect up to 12 h after death of animal without any significance loss in quality of semen in Murrah buffalo bull. Significant strong positive correlation among important characteristics (motility, livability and HOS positive sperm) suggests...
A pluriparus full-term exhausted murrah buffalo aged about 8 years, in its 3rd parity escorted to... more A pluriparus full-term exhausted murrah buffalo aged about 8 years, in its 3rd parity escorted to the TVCC, College of Veterinary Science and Animal Husbandry, ANDUAT, Ayodhya, India, with history of straining since last 12 h. On per vaginum examination, this case was diagnosed as dystocia because of true Schistosoma reflexus. A successful per-vaginal management of dystocia due to Schistosomus reflexus monster by traction and mutation is performed.
Background: Anoestrus is still one of the most prevalent reproductive disorders in dairy cows des... more Background: Anoestrus is still one of the most prevalent reproductive disorders in dairy cows despite technological advances in animal husbandry. Evaluation of blood biochemical profile is of diagnostic value to determine disease or health status of animal. The current study was aimed to evaluate the effect of different therapeutic regimen on blood biochemical profile, oestrus induction response and conception rate of anoestrus cows.Methods: Thirty two postpartum anoestrus cows randomly allocated to four groups as G0 (negative control), GI, GII, GIII, GIV and 8 normal cyclic as GV (positive control). Dewormer and mineral mixture administered to GI, GII, GIII, GIV while group GII, GIII and GIV additionally received janova, sepia and Ovsynch protocol respectively.Result: Different therapeutic protocols have variable effects on blood biochemical parameters. Overall oestrus induction response in G0, GI, GII, GIII, GIV and GV is 0.00, 50, 62.5, 75, 87.5 and 100.00 per cent respectively w...
A total of 100 patients of tetralogy of Fallot aged 13 years and over were operated upon at the A... more A total of 100 patients of tetralogy of Fallot aged 13 years and over were operated upon at the All India Institute of Medical Sciences, New Delhi, India between January 1991 and December 1996. There were 69 males (69%) and 31 females (31%). Age ranged from 13 years to 43 years (mean 19.66 years). Twenty % of patients had preoperative complications like haemoptysis, cerebrovascular accidents, brain abscess and infective endocarditis. Twenty-two patients had previous palliative shunts. Fifteen patients had coil embolisation of major collaterals prior to surgery. In hospital mortality rate was 4%. Follow-up ranged from 1 month to 5 years (mean 3.4 years). There was one late death due to infective endocarditis. Postoperatively 93.6% patients were in NYHA class I. Significant residual defects warranting re-operation were present in three patients. Total correction of tetralogy of Fallot in older patients can be performed with acceptable results.
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