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Biomedical subjects

D Jain

Publications and source records attributed to D Jain.

114 records · Page 7Linked to original sources
PubMedDate not supplied

Neurofibromatosis: a diagnostic mimicker on CT in a known case of malignancy.

A known case of early carcinoma cervix was found to have mediastinal widening on chest radiograph and hypoechoic oval retroperitoneal lesions on USG abdomen. CECT chest and abdomen showed these to be non enhancing lymph node like round to oval discrete mass lesions in mediastinum, abdomen and pelvis. With no other suggestion of carcinoma spread, local or distant and uncommon incidence of extensive lymphadenopathy in a early carcinoma cervix, biopsy from one of the representative lesion was performed which revealed it to be benign neurofibroma. Differentiation of these strategically located benign nerve sheath tumors from lymphadenopathy can sometimes be challenging on CT scan and in a known case of malignancy or with history of surgery for malignant neoplasm it may cause concern for disease spread or local tumor recurrence. Associated imaging and clinical features can sometimes be helpful in reaching the correct diagnosis.

Adult↗
PubMedDate not supplied

Effect of additional oral ofloxacin administration in the treatment of multidrug-resistant tuberculosis.

The effect of additional oral ofloxacin administration was evaluated in 19 HIV-negative patients with multidrug-resistant tuberculosis (MDR-TB). Their mean duration of illness was 3.6 years. Based on chest roentgenograms, 13 patients had advanced disease and 6 had moderate disease. In addition to 'second-line drugs', patients were treated with oral ofloxacin; high dose 800 mg per day (12 patients), low dose 400 mg per day (2 patients) and intermittent twice a week regimen of 800 mg a day (5 patients). With treatment, there was a significant clinical improvement. Sputum smear conversion occurred in 18 patients (mean duration 15 weeks) and this sputum smear negativity persisted for a mean duration of 7 months. Chest roentgenograms revealed regression of lesions in 18 patients. Reversible side effects were encountered in four patients. Results of present study suggest that additional administration of oral ofloxacin is both effective and safe for the treatment of MDR-TB.

Administration, Oral↗
PubMedDate not supplied

One-stop chest pain clinic can identify high cardiac risk.

The aim of this study was to record prognosis for patients with stable chest pain referred for outpatient cardiac assessment. All 660 patients in the study had a normal resting ECG and no history of myocardial infarction, unstable angina or coronary revascularisation. Main outcome measures were all-cause mortality, non-fatal ischaemic events and coronary revascularisation. Cardiac chest pain was diagnosed in 182 patients (28%). It was more frequent in patients with recent onset of symptoms (< 6 months), patients over 50, white patients, and patients with hypertension or diabetes. The mean follow-up was 622 +/- 338 days. Among survivors, 37% continued to suffer from symptoms (cardiac group: 59 (35.1%); non-cardiac group: 177 (38.4%)). When all hard events were considered, event-free survival (95% confidence interval) for the cardiac group was 90.9% (86.7-95.2%) at six months, 88.9% (84.2-93.6%) at one year, and 83.6% (77.5-89.7%) at two years. Corresponding figures for the non-cardiac group at the same time points were better (p < 0.0001): 98.5% (97.4-99.6%), 97.5% (96.1-99.0%) and 96.6% (94.7-98.5%), respectively. In conclusion, the use of clinical criteria in a cardiac outpatient clinic, backed up by simple non-invasive investigations, can reliably identify a population at high risk of subsequent cardiac events.

Adult↗
PubMedDate not supplied

Cytomegalovirus infection masquerading as an ulcerative colitis flare-up: case report and review of the literature.

We report the case of a patient with a case of cytomegalovirus (CMV) colitis, which presented as a flare-up of her ulcerative colitis. Standard treatment for the flare-up, which included intravenous corticosteroids, bowel rest, topical salicylates and ultimately colectomy were not effective. The patient did not improve until therapy with intravenous ganciclovir was initiated. There have been 26 previous reports of CMV colitis complicating inflammatory bowel disease (IBD). The diagnosis is not frequently entertained and, if not made, leads to a high rate of colectomy (67 percent) and mortality (33 percent). Appropriate antiviral therapy appears to eliminate these complications, thus a high index of suspicion for CMV superinfection in cases of IBD refractory to traditional therapy is warranted.

Antiviral Agents↗