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Biomedical subjects

Uday Khopkar

Publications and source records attributed to Uday Khopkar.

11 recordsLinked to original sources
PubMed2006

Morbid adhesion of the placenta after hysteroscopic lysis of intrauterine adhesions.

OBJECTIVE: To report a case of morbidly adherent placenta in a patient who had previously undergone hysteroscopic lysis of intrauterine adhesions. DESIGN: Case report. SETTING: Large district general hospital within the National Health Service in the U.K. PATIENT(S): A healthy 32-year-old woman who had conceived following hysteroscopic lysis of intrauterine adhesions. INTERVENTION(S): Watchful expectancy following the diagnosis of morbidly adherent placenta immediately after delivery. MAIN OUTCOME MEASURE(S): Retention of the uterus and therefore reproductive function. RESULT(S): Successful resolution of the retained placenta following watchful expectancy. CONCLUSION(S): Watchful expectancy is a valid option in the management of a morbidly adherent placenta.

Adult↗
PubMedDate not supplied

Dermoscope.

Explore the source record for details and available documents.

Dermoscopy↗
PubMedDate not supplied

Improving adherence to antiretroviral therapy.

Antiretroviral therapy (ART) has transformed HIV infection into a treatable, chronic condition. However, the need to continue treatment for decades rather than years, calls for a long-term perspective of ART. Adherence to the regimen is essential for successful treatment and sustained viral control. Studies have indicated that at least 95% adherence to ART regimens is optimal. It has been demonstrated that a 10% higher level of adherence results in a 21% reduction in disease progression. The various factors affecting success of ART are social aspects like motivation to begin therapy, ability to adhere to therapy, lifestyle pattern, financial support, family support, pros and cons of starting therapy and pharmacological aspects like tolerability of the regimen, availability of the drugs. Also, the regimen's pill burden, dosing frequency, food requirements, convenience, toxicity and drug interaction profile compared with other regimens are to be considered before starting ART. The lack of trust between clinician and patient, active drug and alcohol use, active mental illness (e.g. depression), lack of patient education and inability of patients to identify their medications, lack of reliable access to primary medical care or medication are considered to be predictors of inadequate adherence. Interventions at various levels, viz. patient level, medication level, healthcare level and community level, boost adherence and overall outcome of ART.

Anti-Retroviral Agents↗
PubMedDate not supplied

Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in community-acquired primary pyoderma.

BACKGROUND: Although prevalence of MRSA strains is reported to be increasing, there are no studies of their prevalence in community-acquired primary pyodermas in western India. AIMS: This study aimed at determining the prevalence of MRSA infection in community-acquired primary pyodermas. METHODS: Open, prospective survey carried out in a tertiary care hospital in Mumbai. MATERIALS AND METHODS: Eighty-six patients with primary pyoderma, visiting the dermatology outpatient, were studied clinically and microbiologically. Sensitivity testing was done for vancomycin, sisomycin, gentamicin, framycetin, erythromycin, methicillin, cefazolin, cefuroxime, penicillin G and ciprofloxacin. Phage typing was done for MRSA positive strains. RESULTS: The culture positivity rate was 83.7%. Staphylococcus aureus was isolated in all cases except two. Barring one, all strains of Staphylococcus were sensitive to methicillin. CONCLUSIONS: Methicillin resistance is uncommon in community-acquired primary pyodermas in Mumbai. Treatment with antibacterials active against MRSA is probably unwarranted for community-acquired primary pyodermas.

Adolescent↗
PubMedDate not supplied

Nasal extranodal NK/T-cell lymphoma presenting as a perforating palatal ulcer: a diagnostic challenge.

A 40-year-old man presented with chronic nasal stuffiness and bloodstained discharge of 3 years' duration, along with a non-healing palatal ulcer since 2 months. Examination revealed a perforation in the midline on the hard palate and a superficial ulcer on the soft palate. Histopathology and immunohistochemistry suggested a diagnosis of extranodal nasal/nasal-type T-cell lymphoma. The patient was started on multiagent chemotherapy in the form of cyclophosphamide, doxorubicin, vincristine and prednisolone but succumbed after two cycles. Only one case of nasal T cell lymphoma presenting as nasal septal perforation, oronasal fistula and a concomitant palatal ulcer has been described. We report this case of a perforating palatal ulcer as a rare presentation of nasal lymphoma.

Adult↗
PubMedDate not supplied

Cutaneous vasculitis as a presenting feature of multiple myeloma: a report of 2 cases.

We report two male patients who presented with symmetrical, painful purpura that evolved into bullae and necrotic ulcers, predominantly on the extremities, over two months in spite of conventional therapy including oral steroids. Examination showed livedoid and purpuric patches with necrotic centers in starburst pattern over the extremities and buttocks. The first case also had similar lesions over the ears. The clinical presentation and the histopathological examination suggested a diagnosis of necrotizing leukocytoclastic vasculitis (LCV). Blood testing ruled out connective tissue disease, hepatitis B or C infection or streptococcal infection as underlying cause of vasculitis. Serum antinuclear factor, antineutrophilic cytoplasmic antibody and anticardiolipin anticoagulant were negative in both cases. Cryoglobulins were positive in case 2. An incidental finding was raised serum proteins and globulins in case 2. Further investigations revealed M band on electrophoresis and features of multiple myeloma on bone marrow biopsy in both cases. These cases emphasize the importance of simple investigations like serum proteins in the evaluation of LCV.

Adult↗