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Byline: Rakesh. Gupta, Mousmi. Agrawal, Archana. Keche, Satyaki. Ganguly Primary cutaneous blastomycosis is very rare in non-endemic regions like India. Only few cases have been reported from India. Herein, we [...]

Underreporting hampers the accurate estimation of the numbers of infant and maternal deaths and stillbirths In India. In Haryana state, a surveillance-based model--the Maternal Infant Death Review System--was launched in 2013 to try to resolve this issue. The system is a mixture of routine passive data collection and active surveillance by specially recruited and trained field volunteers. The volunteers gather the relevant data from child day-care centres, community health centres, cremation grounds, hospitals, the municipal corporation's offices and primary health centres and regularly visit health subcentres. The collected data are triangulated against the standard death registers and discussions with relevant community members. The details of any unregistered death are rapidly uploaded on the system's web-based platform. In April 2014, we made field observations, reviewed records and conducted in-depth interviews with the key stakeholders to see if the system's performance matched the state government's planned objectives. The data collected indicate that implementation of the system has led to quantitative and qualitative improvements in reporting of infant and maternal deaths and stillbirths. Completeness and consistency in the reporting of deaths are essential for focused policy and programmatic interventions and there remains scope for Improvement in Haryana via further reform and changes In policy. The model in its current form is potentially sustainable and scalable in similar settings elsewhere. En Inde, le sous-signalement empeche d'estimer correctement le nombre de deces infantiles et maternels et de mortinaissances. Dans l'Etat d'Haryana, un modele base sur la surveillance--le Maternal Infant Death Review System--a ete lance en 2013 afin de tenter de resoudre ce probleme. Ce systeme melange recueil passif de donnees de routine et surveillance active par des benevoles de terrain specialement recrutes et formes a cet effet. Ces derniers recueillent des donnees aupres de garderies, de centres de sante communautaires, de crematoriums, d'hopitaux, de centres de soins primaires et des bureaux des municipalites et se rendent regulierement dans des centres de soins secondaires. Les donnees ainsi recueillies sont triangulees par rapport aux registres standards des deces et aux discussions avec des membres de la communaute. Les details de tout deces non enregistre sont rapidement charges sur la plate-forme Internet du systeme. En avril 2014, nous avons effectue des observations de terrain, examine des registres et mene des entretiens approfondis avec les principales parties prenantes afin de voir si les performances du systeme repondaient aux objectifs du gouvernement de l'Etat. Les donnees recueillies indiquent que-la mise en oeuvre de ce systeme a entraine une amelioration quantitative et qualitative du signalement des deces infantiles et maternels ainsi que des mortinaissances. Lexhaustivite et la coherence du signalement des deces sont essentielles pour avoir des politiques ciblees et des interventions programmatiques, et l'Etat d'Haryana presente d'autres possibilites d'amelioration, via d'autres reformes et des changements strategiques. Le modele, dans sa forme actuelle, est potentiellement utilisable a long terme et transposable dans des lieux similaires. La escasez de informes obstaculiza una estimacion exacta de las cifras de muertes maternas e infantllesy mortinatos en India. En 2013, en el estado de Haryana, se lanzo un modelo basado en el seguimiento (el Sistema de Analisis de la Mortalidad Infantil y Materna) para tratar de resolver este problema. El sistema combina una recopilacion de datos rutinarios pasivos y un seguimiento activo realizados por voluntarios contratados capacitados en este campo. Los voluntarios reunen informacion relevante de guarderias, centros de salud, terrenos destinados a incineraciones, hospitales, oficinas de la'corporacion municipal y centros de atencion primaria, y visitan con asiduidad subcentros de salud. Los datos-recopilados se triangulan segun los registros normalizados de fallecimientos y analisis con miembros relevantes de la comunidad. Los detalles sobre todas las muertes no registradas se Introducen con rapidez en la plataforma en linea del sistema. En abril de 2014, se realizaron observaciones de campo, se analizaron los registros y se llevaron a cabo entrevistas en profundidad con las partes interesadas fundamentales para comprobar que el rendimiento del sistema se equiparaba con los objetivos planificados por el gobierno estatal. Los datos recopilados indican que la implementadon del sistema logro mejoras cuantitativas y cualitativas a la hora de redactar informes sobre la mortalidad infantil y materna y los mortinatos. Es fundamental que los informes sobre los fallecimientos sean minuciosos y coherentes para poder realizar Intervenciones politicasy programaticas, y sigue existiendo margen para Implementar mejoras en Haryana mediante mas reformas y cambios de las politicas. El modelo actual puede mantenerse y ampliarse en otras ubicaciones similares., Introduction Each year in India, there are approximately 28 million pregnancies, 26 million live births, 67 000 maternal deaths and a million neonatal deaths. (1) There are about 42 infant [...]

Byline: Sanghamitra. Ray, Rakesh. Gupta, Deepti. Jain Transfusion-related acute lung injury (TRALI) is a transfusion-related adverse effect associated with high mortality, manifesting with acute respiratory distress and with features of [...]

Byline: Radha. Verma, Sunita. Ahlawat, Rana. Patir, Rakesh. Gupta Sir, A 53-year old gentleman presented on 21/10/2012 with an episode of generalized tonic and clonic seizure. Magnetic resonance imaging (MRI) [...]

Byline: Vaibhav. Varshney, Rakesh. Gupta, Sundeep. Saluja, Ila. Tyagi, Pramod. Mishra, Vineeta. Batra INTRODUCTION: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. We analyzed [...]

Byline: Jitender. Saini, Pradeep. Gupta, Praveen. Gupta, Ravi. Yadav, Nishtha. Yadav, Rakesh. Gupta Background: Perilesional gliosis is an important substrate for seizures in patients harboring a calcified neurocysticercosis (NCC) lesion [...]

Byline: Rakesh. Gupta, Vineeta. Batra, Suniti. Pahwa, Shaam. Bodeliwala, Anita. Jagetia, Daljit. Singh, Hukum. Singh Sir, Giant cell tumors (GCTs), also known as osteoclastomas, are rare primary bone tumors comprising [...]

Byline: Rakesh. Gupta, Vineeta. Batra, Daljit. Singh, Mehar. Sharma, Vikas. Kumar Spindle cell oncocytoma (SCO) is a newly described rare entity simulating clinicoradiological features of a nonfunctional pituitary adenoma and [...]

Byline: Rakesh. Gupta Dynamic contrast-enhanced (DCE) MRI gives quantitative information about the integrity of the vascular system and has been used in brain tumors, infections and multiple sclerosis.[1],[2],[3],[4] It has [...]

Byline: Jayant. Vishal, Rana. Patir, Sunita. Ahlawat, Rakesh. Gupta We present an unusual case of primary diffuse craniospinal leptomeningeal gliomatosis (PGDL), who was initially diagnosed on the basis of imaging, [...]

Byline: Rakesh. Gupta Small vessel central nervous system vasculitis (SVCNSV) is a rare and poorly understood syndrome. Its diagnosis is challenging because of a wide spectrum of clinical presentations and [...]

Background: Globally, India is recognized for providing comprehensive coverage of tobacco cessation through the infrastructure and resources over the last two decades. Nevertheless, its current tobacco burden is worrying due to an increase in ~2 million initiators and 5.87% tobacco related deaths annually. Objective: It was to identify and describe challenges and barriers in tobacco cessation delivery that exist at various levels of health care as well as at the level of tobacco users, their care givers and communities in which they live. Method: Besides authors' first-hand collective experience in the tobacco control for over 80 years and ~35 years in tobacco cessation and reviewed references, the stakeholders communications during various events along with telephonic or in-person with some of them were assimilated to comprehend an overall understanding of the issue. Results: The challenges and barriers are primarily due to low priority assigned by the relevant functionaries, the inadequacy of resources, poor engagement of health-and insurance-sectors and healthcare workers, a low intent to quit by its users, suboptimal and discontinuous enforcement of the Cigarette and Other Tobacco Products Act of 2003 (COTPA), and indifference of the non-users. Conclusion: The countrywide strategic initiatives required "as a package" should include political and bureaucratic commitment, mass communication on benefits of quitting, licensed current users quitting through a timeline, use of systems approach in tobacco cessation delivery, implementation, and enforcement of vendor licensing and the proposed amendments in COTPA. Their perceived benefits will become a win-win situation for all stakeholders engaged in tobacco cessation delivery. [ABSTRACT FROM AUTHOR]

Byline: Rakesh. Gupta, Harshad. Patil Sir, A 45-year-old female patient came to our hospital, with the chief compliants of numbness in both the upper limbs for the last 3 months [...]

Byline: Kalpana. Kumari, Mehar. Sharma, Aanchal. Kakkar, Prit. Malgulwar, Pankaj. Pathak, Vaishali. Suri, Chitra. Sarkar, Sarat. Chandra, Mohammed. Faruq, Rakesh. Gupta, Ravindra. Saran Background: Subependymal giant cell astrocytomas (SEGA) are [...]

Byline: Rakesh. Gupta It is well known that early diagnosis and treatment is the key to management of tuberculous meningitis (TBM). Cranial neuropathy, hydrocephalus and vasculitis are poor clinical predictors [...]

Byline: Rakesh. Gupta, Kaushik. Majumdar, Anita. Jagetia, Ravindra. Saran Sir, Primary Ewing's sarcoma (ES) of the cranial bone is uncommon and accounts for A 12-year-old male child was referred to [...]

Byline: Rakesh. Gupta, Harshad. Patil Parry-Romberg syndrome (PRS) is a rare, poorly understood degenerative condition characterized by atrophic changes affecting one side of the face. The cause of these changes [...]

Byline: Rakesh. Gupta Perfusion magnetic resonance imaging (MRI) is currently being used in the evaluation of brain tumors. A number of papers are available in the literature utilizing this technique [...]

Byline: Rakesh. Gupta, Abhishek. Songara Synchronous intracranial germ cell tumor in the pineal and suprasellar region is rare. They represent only 5-10% of all intracranial germinomas. They are also known [...]

Background: Some patients with focal cerebral calcification (FCC) have no seizure or a benign course of epilepsy, whilst others with a similar lesion have uncontrolled epilepsy. Aims: To look for [...]

Byline: Rakesh. Gupta, Akshat. Kayal Scalp arteriovenous malformations are an exceptional group of vascular lesions with curious presentations and an elusive natural history. Their detection in the pediatric population is [...]

Byline: Ashwin. Kallianpur, Shivpreet. Samra, Vinod. Nimbran, Rakesh. Gupta, Cherian. Akkarappatty, Nidhi. Gupta, Gaurav. Gupta Transdiaphragmatic approach to the pericardium through a subxiphoid incision is a safe, rapid, and effective [...]

Byline: Vimal. Paliwal, Sushil. Rahi, Prabhat. Singh, Rakesh. Gupta Sir, A 45-year-old gentleman presented with progressive weakness of all four limbs, change in voice, swallowing difficulty and spells of excessive [...]

Byline: Vinod. Khurana, Rakesh. Gupta, Leela. Pant, Sanjay. Jain, Kapil. Chandra, Yukti. Sharma An 8-week-old infant presented with 7 weeks history of nail involvement and discoloration. Lesions started over the [...]

* Objective.--A 5 1/2-year-old boy presenting with virilization was diagnosed as having classic 21-hydroxylase deficiency complicated by an adrenal tumor. We attempted to document a reduction in the size of the tumor with glucocorticoid therapy. Design.--Case study. Setting.--Referral center. Intervention.--Glucocorticoid therapy was instituted for congenital adrenal hyperplasia. Surgery for the adrenal mass was deferred, and the size of the mass was monitored by serial ultrasonography. Results.--Baseline values of serum 17[alpha]-hydroxyprogesterone (186.6 nmol/L) and testosterone (24.7 nmol/L [7.1 ng/mL]) were elevated. After instituting steroid treatment, 17[alpha]-hydroxyprogesterone was suppressed (13.0 nmol/L), and testosterone remained undetectable on follow-up. However, the size of the mass increased during 6 months. Unilateral adrenalectomy performed at that time revealed a well-encapsulated adenoma in a hyperplastic gland. Conclusions.--Untreated classic congenital adrenal hyperplasia may be complicated by an adrenal tumor even at a young age. Suppression of adrenal androgens by glucocorticoid therapy was not accompanied by regression of the tumor in our patient. (AJDC. 1993;147:1321-1323), An adrenal tumor in conjunction with congenital adrenal hyperplasia may not regress with hormone treatment and may need to be removed surgically. Congenital adrenal hyperplasia causes early sexual development in males and development of male characteristics in females. It occurs when an enzyme deficiency causes a hormonal imbalance resulting in excess androgen production. A 5 1/2-year-old boy was diagnosed with congenital adrenal hyperplasia. He was tall and heavy for his age, and he had an enlarged penis and pubic hair. A tumor was detected in the left adrenal gland and the right gland was enlarged. Hormone therapy was begun and surgery was delayed to see if the tumor would shrink. The hormone therapy effectively suppressed androgen production, but the tumor continued to grow. After six months, surgery was performed to remove the tumor.

Byline: Rakesh. Gupta, Vijay. Parihar, Jyoti. Sanghvi Introduction Medulloblastoma is the most common primary central nervous system tumor in children. The cause of medulloblastoma is unknown. It has been associated [...]

Byline: Krishan. Jain, Shireesh. Mittal, Sunil. Kumar, Rakesh. Gupta Fungal infections of the central nervous system (CNS) are rare in the general population and are invariably secondary to primary focus [...]