Kiran Wandile

SEVA TB ELISA - MULTI ANTIGEN AND ANTIBODY ASSAYS FOR SERODIAGNOSIS OF SUSPECTED CASES OF PULMONARY AND EXTRA PULMONARY TUBERCULOSIS IN TERTIARY CARE HOSPITAL - A RETROSPECTIVE STUDY

Abstract Objective To assess the usefulness of in-house developed multiantigen and antibody assays, in diagnosis of both pulmonary and extra-pulmonary tuberculosis. Method Clinically suspected cases of 31 pulmonary and 171 extra-pulmonary tuberculosis (TB) were screened by ELISA using cocktail (ES-31 + EST-6) antigen and their specific antibodies (anti ES-31 + anti EST-6 IgG) for detection of antibody and and antigen (circulating antigen and immune complexed antigen) respectively and correlated with antituberculosis therapy in retrospective study. Results Out of 31 cases of pulmonary TB screened, 15 patients showed ELISA positivity out of which five cases were given antituberculosis therapy. Out of 171 cases of EPTB screened, 76 cases showed ELISA positivity out of which 18 were given antituberculosis therapy. Further 4 EPTB cases which showed AFB negativity were given ATT. The data was further analyzed based on PTB & EPTB, adults and children, OPD and IPD patients to understand false positivity in clinically suspected PTB and EPTB cases. There was significant correlation (108/202 cases) with ELISA negativity and no ATT advised in clinically suspected PTB and EPTB patients. Conclusions In house developed multi antigen and antibody assays have been observed to be quite useful as adjunct test in serodiagnosis of suspected cases of tuberculosis in particular extrapulmonary tuberculosis.

Hydroxyapatite granules for the surgical treatment of calcaneal intraosseous lipomas: A case report

Intraosseous lipoma of calcaneus is a rare occurrence. It is a benign tumor and frequently associated with pain in heel. Diagnosis can be done by a biopsy of the lesion. This tumor can be treated with curettage and filling cavity with hydroxyapatite granules. We present a case of intraosseous lipoma treated with curettage and hydroxyapatite granules.

Custom prosthetic reconstruction of distal femoral giant cell tumor

Giant cell tumor (GCT) also called osteoclastoma of bone is the most common bone tumor encountered by an orthopedic surgeon. GCT generally occurs in skeletally mature individuals with peak incidence in the third decade of life. Less than 5% are found in patients with open physis and only about 10% of cases occur in patients older than 65 years. We present a case of distal femoral GCT managed with custom mega prosthetic arthroplasty.

Spinal synovial cyst

Synovial cysts are uncommon in spine. In spine, they can occur in cervical, thoracic or lumbar region whereas they are the most common in the lumbar spine. These cysts are associated with pain in back with radicular pain. Magnetic resonance imaging (MRI) scan of the spine is best diagnostic modality for these cysts. Furthermore computed tomography scan can be used. Surgical treatment is necessary for excision of the cyst. Complete excision of cyst gives good results. We present a case of L4-L5 synovial cyst diagnosed with MRI scan and treated with posterior surgical excision.

Custom mega prosthetic reconstruction of juxta articular giant cell tumors

Introduction: Giant cell tumor (GCT) also called osteoclastoma of bone is the most common osteolytic bone tumor encountered by an orthopedic surgeon. En bloc resection of major joints creates a problem for the reconstruction of large defects. Recent advances in tumor resection defects involve the use of custom-built joints for the reconstruction of defects near joints. This article analyzes the functional outcomes after resection of juxta articular GCTs and reconstruction by custom mega prosthetic arthroplasty. Aims and Objectives: To study the functional results of custom mega prosthetic reconstruction in juxta articular GCTs with intra articular extension. Materials and Methods: Four patients with juxta articular GCTs around the hip and knee with mean age of 40 yrs (range 30 to 50 yrs) underwent resection and reconstruction by custom mega prosthetic arthroplasty during the period 2011 to 2013. Two patients were males and two were females. All of them were in Enneking stage 3. Proximal femur was involved in one patient, distal femur in one and proximal tibia in two patients. Results: Functional results were analyzed using Ennekings criteria. Excellent results were obtained in all the patients without recurrence, periprosthetic fractures, infections or aseptic loosening. Conclusion: By using the technique of custom mega prosthetic reconstruction in juxta articular GCTs with pathological fractures or intra articular extension, the desired goals of reconstruction with good functional results and least complications can be achieved.

Custom prosthetic reconstruction of proximal tibial giant cell tumor

Giant cell tumor (GCT) also called osteoclastoma of bone is the most common bone tumor encountered by an orthopedic surgeon. GCT generally occurs in skeletally mature individuals with peak incidence in the third decade of life. Less than 5% are found in patients with open physis and only about 10% of cases occur in patients older than 65 years. We present a case of proximal tibia GCT managed with custom mega prosthetic arthroplasty.