Browsing by Author "Manoj Meena"

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A study to compare prognostic utility of procalcitonin with existing biomarkers (CRP and TLC) and clinical risk scores (PSI and CURB 65) in community acquired pneumonia
(Mrs Deepika Charan, 2015) Sudhir Agarwal; Manoj Meena; Arvind Misra; Lalit Meena; Mrityunjaya Singh
Background: Community-acquired pneumonia (CAP) is a leading cause of morbidity and mortality. Biomarkers are increasingly being used to distinguish bacterial pneumonia from other causes, to help reduce the duration of antibiotic therapy, and to assess the prognosis of CAP and thereby aiming to complement Pneumonia Severity Index (PSI) and other scores.; Aims & Objective: To compare prognostic utility of procalcitonin (PCT) with existing biomarkers [C-reactive protein (CRP) and total leukocyte count (TLC)] and clinical risk scores (PSI and CURB-65).; Materials and Methods: Fifty patients diagnosed with CAP were included in this study. Baseline serum PCT was measured, which was then stratified according to four predetermined tiers (tier I: <0.1; tier II: 0.1 to <0.25; tier III: 0.25 to <0.5; tier IV: ≥0.5 µg/L). To calculate the severity of pneumonia, patients were classified according to PCT tier, PSI, and CURB-65 scores. Follow-up PCT and reclassification of PSI and CURB-65 were carried out on days 4 and 30.; Results: PCT was more significantly associated with positive bacterial culture than CRP and TLC. Initial PCT level was significantly correlated with TLC (p = 0.044), CRP (p < 0.001), PSI (p < 0.001), and CURB-65 (p = 0.028).; Conclusion: Findings in our study showed that the management of severe CAP would be greatly improved if it were possible to identify, early in the course of disease, those patients who are most likely to develop complications and are at the risk of mortality. © 2015 Mrs Deepika Charan. All rights reserved.
Acute silicosis with bilateral pneumothorax
(BMJ Publishing Group, 2014) G.N. Srivastava; Rajniti Prasad; Manoj Meena; Moosa Hussain
We present a case of acute silicosis with bilateral pneumothorax of a 28-year-old man working at a stone crusher factory for 1 year. He presented to the emergency department with cough, respiratory distress and diffuse chest pain. The patient was managed with bilateral intercostal tube drainage under water seal, oxygen inhalation and conservative therapy. On follow-up he showed improvement of resting dyspnoea and was doing well. This case is being reported because of the rare complications of acute silicosis as bilateral pneumothorax. Copyright 2014 BMJ Publishing Group. All rights reserved.
Clinical tools and biochemical markers to assess short-term mortality in acute exacerbation of chronic obstructive pulmonary disease (COPD)
(Journal of Clinical and Diagnostic Research, 2018) Govind Narayan Srivastava; Manoj Meena; Ankit Patel; Ashok Singh Charan; Mukesh Goyal; Piyush Arora; Ramniwas Meena
Introduction: Acute exacerbation of COPD is one of the leading causes of death worldwide. Aim: This study was aimed to study the role of clinical tools and biochemical markers which have significant impact on short-term mortality in COPD patients presenting with acute exacerbation. Material and Methods: A total of 50 patients were studied. Patients of age >40 years having COPD exacerbation and presenting with two of the three cardinal features of exacerbation: increase in amount of cough, increase in purulence of cough, increase in baseline dyspnoea which were severe enough to necessitate a hospital admission, were evaluated after admission. A thorough history taking and clinical examination was performed along with all necessary laboratory parameters were studied. Study population was followed for 30 days. Data was analysed using Chi-square test and multivariate regression analysis using SPSS version 16.0. Results: Out of 50 patients, 30% (15/50) did not survive despite treatment. Parameters such as, history of mechanical ventilation in past one year, low GCS (Glasgow Coma Scale), raised JVP (Juglar Venous Pressure), low pH and raised IL-6 levels were significantly associated with mortality in multivariate analysis (p-value <0.05). Conclusion: Severity of disease as well as severity of present exacerbation was related with short-term mortality. Interleukin-6 is an independent predictor of mortality. Parameters like past history of mechanical ventilation and raised JVP point towards the need of overall better management of COPD patients not only during exacerbations. © 2018, Journal of Clinical and Diagnostic Research. All rights reserved.
Home-based long-term oxygen therapy and oxygen conservation devices: An updated review
(Mrs Deepika Charan, 2015) Manoj Meena; Ramakant Dixit; Jai Prakash Kewlani; Surendra Kumar; Sabarigirivasan Harish; Dheeraj Sharma; Mrityunjaya Singh
Oxygen therapy has long become a cornerstone in the treatment of patients with chronic obstructive pulmonary diseases and other hypoxemic and hypercapnic chronic respiratory diseases. Studies have clearly shown benefits in terms of survival, improvement in dyspnea, exercise tolerance, and other associated conditions like pulmonary hypertension that arise due to the disease. However, guidelines regarding prescription of oxygen and to make choice of the delivery devices are not explicit. Furthermore, there still prevails a large unawareness and confusion among physicians to properly prescribe and advise patients about the use of oxygen for home therapy customized as per individual needs. The availability of several new oxygen delivery and conservation devices and techniques over the past few decades has provided a wide spectrum of options to be used in combinations or alone. This article retrospectively tries to review the studies, trials, and researches published so far in this field to give a broad idea based on consistent scientific evidence to help physicians frame their set of guidelines for prescribing long-term oxygen therapy. © 2015 Manoj Meena.
Nocardia farcinica as a causative agent of lung abscess
(Wolters Kluwer Medknow Publications, 2015) Manoj Meena; Ramakant Dixit; Harish Sabarigirivasan; Govind Narayan Srivastava; Lalit Prashant Meena
[No abstract available]
Primary/local hepatic tuberculosis without dissemination
(BMJ Publishing Group, 2015) Manoj Meena; Ramakant Dixit; Lalit Prashant Meena; Jai Kumar Samaria
We present a rare case of primary hepatic tuberculosis in a 50-year-old man who presented with pain at the right hypochondrium. The diagnosis was established by fineneedle aspiration cytology (FNAC) of the primary hepatic lesions in both lobes of the liver, which was further supported by histopathological examination and tissue PCR for Mycobacterium tuberculosis in the FNAC specimens. Copyright © 2015 BMJ Publishing Group.
Surgical and bronchoscopic lung volume reduction in chronic obstructive pulmonary disease
(Hindawi Limited, 2014) Manoj Meena; Ramakant Dixit; Mrityunjaya Singh; Jai Kumar Samaria; Surendra Kumar
Chronic obstructive pulmonary disease (COPD) is the most extensively studied and researched disease in pulmonology and a cause of significant morbidity, mortality, and financial burden on patient's family and country's economy. Its management continues to be a challenge to both the physician and the patient's family. So far, it is preventable and treatable but not curable. Emphysema, a phenotype of COPD, is the most debilitating condition associated with progressive exercise intolerance and severe dyspnea. Despite decades of research, medical treatments available so far have helped improve quality of life and slowed down the decline in respiratory function but did not significantly improve the survival benefits. Though surgical lung volume reduction (LVR) procedures have shown some promise in context to functional gains and survival but, only in a carefully selected group of patients, bronchoscopic LVR procedures are yet to explore their full potential and limitations. This paper retrospectively studied the developments so far, medical and surgical, with special emphasis on the bronchoscopic procedures of lung volume reduction, and tried to comparatively analyze the risks and benefits of each one of them through various trials and studies done to date. © 2014 Manoj Meena et al.
Tuberculosis of the triceps muscle
(BMJ Publishing Group, 2015) Manoj Meena; Ramakant Dixit; Jai Kumar Samaria; Sabarigirivasan Harish Vijayakandeepan Kumaresan
A tubercular swelling of the triceps muscle in a 25-yearold immunocompetent man is described in this report. He presented with hard, fixed swelling at the lower end of the triceps muscle. Confirmatory diagnosis was established by fine-needle aspiration cytology (FNAC) of the swelling with subsequent PCR for Mycobacterium tuberculosis of the FNAC specimen. The patient was completely cured with antitubercular therapy. Copyright 2015 BMJ Publishing Group. All rights reserved.