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  1. Article: Challenges for setting up psychiatric services in a trauma centre in India.

    Chawla, Nishtha / Chadda, Rakesh K

    BJPsych international

    2024  Volume 21, Issue 1, Page(s) 4–7

    Abstract: Psychiatric sequelae may occur following traumatic injury irrespective of whether an insult has been caused to the brain. A range of psychiatric illnesses have been either causative of or associated with road traffic accidents and traumatic injuries, ... ...

    Abstract Psychiatric sequelae may occur following traumatic injury irrespective of whether an insult has been caused to the brain. A range of psychiatric illnesses have been either causative of or associated with road traffic accidents and traumatic injuries, including depression, anxiety, post-traumatic stress disorder, substance use disorder and attention-deficit hyperactivity disorder. Despite literature on such associations, psychiatric intervention in the treatment of patients following traumatic injury is limited. The authors share their experience of challenges in addressing mental health problems in a tertiary care trauma centre located in North India. Steps in overcoming those challenges included: developing a semi-structured form to be completed for referrals and consultations, a psychiatrist attending weekly rounds with the surgeons, and initiating a psychiatry out-patient clinic for patients discharged from the trauma centre. It may be worthwhile in the future to set up a trauma psychiatry unit at the centre, involving a clinical psychologist, a psychiatric social worker and an occupational therapist for the comprehensive care of patients.
    Language English
    Publishing date 2024-01-18
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2905058-3
    ISSN 2058-6264 ; 2056-4740
    ISSN (online) 2058-6264
    ISSN 2056-4740
    DOI 10.1192/bji.2023.35
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  2. Article: Pattern of adult psychiatric emergencies at a tertiary care center before and after the onset of the COVID-19 pandemic.

    Sen, Mahadev S / Chawla, Nishtha / Deep, Raman / Chadda, Rakesh K

    Indian journal of psychiatry

    2024  Volume 66, Issue 1, Page(s) 106–110

    Abstract: A gap exists in published data on psychiatric emergencies presenting to Indian centers over the entire pandemic. We assessed 2,048 consecutive adult psychiatric emergencies for the period April 2019-September 2021 to compare 18 months following the onset ...

    Abstract A gap exists in published data on psychiatric emergencies presenting to Indian centers over the entire pandemic. We assessed 2,048 consecutive adult psychiatric emergencies for the period April 2019-September 2021 to compare 18 months following the onset of the pandemic, with the pre pandemic year as the control. Mean age was 33.8 ± 13.6 years, with 55% females. The proportion with ICD-10 schizophrenia and related psychotic disorders (18.9% vs 15.3%;
    Language English
    Publishing date 2024-01-25
    Publishing country India
    Document type Journal Article
    ZDB-ID 221523-8
    ISSN 0019-5545
    ISSN 0019-5545
    DOI 10.4103/indianjpsychiatry.indianjpsychiatry_569_23
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  3. Article: Diaphragmatic rupture in case of COVID-19 pneumonia- A rare presentation.

    Chawla, Aditya / Chaudhary, Gaurav / Sachdeva, Primal / Chawla, Madhav K / Chawla, Rakesh K

    Lung India : official organ of Indian Chest Society

    2022  Volume 39, Issue 4, Page(s) 371–373

    Abstract: We describe the case of a male patient admitted to our emergency department during the COVID-19 pandemic with complaints of fever, severe breathlessness and dry cough associated with symptoms of gastric reflux for 5 days. Chest HRCT showed subtle ... ...

    Abstract We describe the case of a male patient admitted to our emergency department during the COVID-19 pandemic with complaints of fever, severe breathlessness and dry cough associated with symptoms of gastric reflux for 5 days. Chest HRCT showed subtle multiple areas of diffuse patchy opacities with ground-glass haze with associated left subdiaphragmatic hernia and atelectasis of the left pulmonary lobe. Barium meal revealed subdiaphragmatic hernia. A nasopharyngeal swab for 2019-nCoV was positive. A diagnosis of diaphragmatic hernia in COVID-19 pneumonia was made. To our knowledge, spontaneous herniation of the diaphragm is a rare entity. Treatment for COVID-19 and empiric antibiotic therapy were promptly started and a decision of elective surgery was made.
    Language English
    Publishing date 2022-07-08
    Publishing country India
    Document type Case Reports
    ZDB-ID 2410801-7
    ISSN 0974-598X ; 0970-2113
    ISSN (online) 0974-598X
    ISSN 0970-2113
    DOI 10.4103/lungindia.lungindia_336_21
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  4. Article: Cryoablation of vocal cord polyp.

    Chawla, Rakesh K / Chawla, Aditya / Chaudhary, Gaurav / Chawla, Madhav / Sareen, Manoj

    Lung India : official organ of Indian Chest Society

    2021  Volume 38, Issue 4, Page(s) 394–395

    Language English
    Publishing date 2021-07-14
    Publishing country India
    Document type Journal Article
    ZDB-ID 2410801-7
    ISSN 0974-598X ; 0970-2113
    ISSN (online) 0974-598X
    ISSN 0970-2113
    DOI 10.4103/lungindia.lungindia_706_20
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  5. Article ; Online: Prophylactic dexamethasone for rebound pain after peripheral nerve block in adult surgical patients: systematic review, meta-analysis, and trial sequential analysis of randomised controlled trials.

    Singh, Narinder P / Makkar, Jeetinder K / Chawla, Janeesha K / Sondekoppam, Rakesh V / Singh, Preet M

    British journal of anaesthesia

    2023  Volume 132, Issue 5, Page(s) 1112–1121

    Abstract: Background: Rebound pain occurs after the resolution of peripheral nerve block and hampers patient recovery in the postoperative period. We sought to synthesise available data from randomised controlled trials (RCTs) evaluating the efficacy of ... ...

    Abstract Background: Rebound pain occurs after the resolution of peripheral nerve block and hampers patient recovery in the postoperative period. We sought to synthesise available data from randomised controlled trials (RCTs) evaluating the efficacy of prophylactic dexamethasone for rebound pain in adult patients undergoing surgery with a peripheral nerve block.
    Methods: In this systematic review and meta-analysis, RCTs reporting rebound pain and use of dexamethasone in the context of a peripheral nerve block were searched in various databases and updated in May 2023. The primary outcome was the incidence of rebound pain; secondary outcomes included the severity and time to onset of rebound pain, patient satisfaction with pain control, sleep disturbance because of pain, and adverse effects of dexamethasone. Subgroup analysis was conducted based on the effect of route of administration (intravenous or perineural) on the incidence of rebound pain. Trial sequential analysis was performed to rule out the possibility of a false positive result.
    Results: Seven RCTs comprising 574 patients were included in this review. The dexamethasone group was associated with a reduction in the incidence of rebound pain with an odds ratio of 0.16 (95% confidence interval 0.10-0.27, P=0.00, I
    Conclusions: Current evidence suggests that both intravenous and perineural dexamethasone reduce the incidence of rebound pain after a peripheral nerve block provided for postoperative analgesia.
    Systematic review protocol: PROSPERO CRD42023424031.
    MeSH term(s) Adult ; Humans ; Nerve Block/adverse effects ; Systematic Reviews as Topic ; Pain, Postoperative/prevention & control ; Pain, Postoperative/etiology ; Dexamethasone/therapeutic use ; Peripheral Nerves ; Anesthetics, Local ; Randomized Controlled Trials as Topic
    Chemical Substances Dexamethasone (7S5I7G3JQL) ; Anesthetics, Local
    Language English
    Publishing date 2023-10-26
    Publishing country England
    Document type Meta-Analysis ; Journal Article ; Review
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2023.09.022
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  6. Article: Mycobacterium W. - An unusual side effect.

    Chawla, Rakesh K / Chawla, Aditya K / Chaudhary, Gaurav / Chopra, Kamal / Chawla, Madhav K

    The Indian journal of tuberculosis

    2021  Volume 69, Issue 2, Page(s) 250–252

    Abstract: Objective: To present an interesting case of unusual side effect of Mycobacterium W. in an adult COVID 19 positive male and discuss its assessment and management.: Methods: - DESIGN: Case Report.: Setting: Tertiary care hospital.: Patient: One.! ...

    Abstract Objective: To present an interesting case of unusual side effect of Mycobacterium W. in an adult COVID 19 positive male and discuss its assessment and management.
    Methods: - DESIGN: Case Report.
    Setting: Tertiary care hospital.
    Patient: One.
    Results: 70 years male was admitted with complaints of fever, persistent dry cough since 10-12 days and progressive breathlessness since 3-4 days. Patient was found COVID-19 RTPCR positive and is known case of Type-II Diabetes with CAD (Post PTCA). Patient was managed conservatively with Oxygen support, I/V antibiotics, I/V Steroids, oral Favipiravir and other supportive treatment. Patient was also given injection Mycobacterium W. in dose of 0.3 ml per day intradermally at 3 different sites (both deltoids) consecutively for three days. 7-8 days after administration, patient developed bright red pustules which later got converted into small punched out ulcerations on all nine local sites of administration, which were managed conservatively with oral analgesics and local steroids for 8-10 days which healed without any scar formation.
    Conclusion: Injection Mycobacterium W. is used in COVID 19 patients as an immunomodulator agent and has been proved to be safe in most of the cases but we encountered this unusual side effect of bright red pustules formation at all nine local sites of injection in our case most likely because of being administered subcutaneously instead of intradermally, making this an interesting case which is being reported to scientific fraternity.
    MeSH term(s) Adjuvants, Immunologic ; Adult ; Anti-Bacterial Agents ; COVID-19 ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Male ; Mycobacterium
    Chemical Substances Adjuvants, Immunologic ; Anti-Bacterial Agents
    Language English
    Publishing date 2021-03-02
    Publishing country India
    Document type Case Reports ; Journal Article
    ZDB-ID 603129-8
    ISSN 0019-5707 ; 0019-5705
    ISSN 0019-5707 ; 0019-5705
    DOI 10.1016/j.ijtb.2021.02.013
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  7. Article: Beware of spurious tracheo-bronchial stents.

    Chawla, Rakesh K / Chopra, Kamal / Chawla, Aditya K / Chaudhary, Gaurav / Sinha, Ashish / Chawla, Madhav K

    The Indian journal of tuberculosis

    2021  Volume 69, Issue 2, Page(s) 253–256

    Abstract: Objective: To present a case of accidental sheath removal of tracheo-bronchial self-expandable metallic airway stent in a patient with endotracheal tumour.: Methods: Design: Case Report; Setting: Tertiary care hospital; Patient: One.: Results: A ... ...

    Abstract Objective: To present a case of accidental sheath removal of tracheo-bronchial self-expandable metallic airway stent in a patient with endotracheal tumour.
    Methods: Design: Case Report; Setting: Tertiary care hospital; Patient: One.
    Results: A 65 years male, follow up case of endotracheal tumor with tracheo-bronchial self-expandable metallic stenting done presented with dry cough and difficulty in breathing since 8-10 days and suddenly coughed out thin whitish paper-like material 2 days back (which later proved as sheath of metallic stent). Direct laryngoscopy with flexible videobronchoscopy was done which showed tracheal stent well placed and intact, coughed out sheath couldn't be replaced back. Procedure was uneventful and patient was discharged in satisfactory condition and is doing well on regular follow up.
    Conclusion: Self-expandable metallic airway stents (SEMAS) represents a standard method of airways stenting especially when employed for the management of malignant central airway obstruction. Despite the obvious stenting advantages, it may be complicated with stent migration and accidental removal or coughing out of stent especially in high tracheal stenosis. In our case, as a peculiar complication there was accidental removal of the tracheal stent sheath which couldn't be replaced back whereas stent was well in place and intact. We need to be beware of such spurious tracheo-bronchial stents.
    MeSH term(s) Airway Obstruction/etiology ; Humans ; Male ; Neoplasms ; Self Expandable Metallic Stents/adverse effects ; Stents/adverse effects ; Tracheal Stenosis/etiology ; Tracheal Stenosis/surgery
    Language English
    Publishing date 2021-10-05
    Publishing country India
    Document type Case Reports ; Journal Article
    ZDB-ID 603129-8
    ISSN 0019-5707 ; 0019-5705
    ISSN 0019-5707 ; 0019-5705
    DOI 10.1016/j.ijtb.2021.09.015
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  8. Article: Internet use among persons with common mental disorders: A qualitative study.

    Sood, Mamta / Pendse, Sachin / Sharma, Mona R / Chawla, Nishtha / Chadda, Rakesh K

    Industrial psychiatry journal

    2023  Volume 32, Issue 2, Page(s) 240–246

    Abstract: Aims and objectives: To assess the current patterns and experience of internet use among persons with depressive and anxiety disorders, particularly for health-related issues.: Methodology: In-depth interviews were conducted with persons diagnosed ... ...

    Abstract Aims and objectives: To assess the current patterns and experience of internet use among persons with depressive and anxiety disorders, particularly for health-related issues.
    Methodology: In-depth interviews were conducted with persons diagnosed with depressive and anxiety disorders (DSM-5), aged ≥18 years who could read and write in Hindi/English, using an interview guide. The interview guide contained questions related to internet use in daily life, internet use for health-related issues, and internet use for stress, and internet use for anxiety/depressive disorder. Interview data were transcribed and analyzed to identify codes and subsequently themes.
    Results: A total of 20 subjects; 10 each diagnosed with depressive and anxiety disorders were interviewed. About half the participants could operate internet independently, while rest required assistance. YouTube was the most common search engine used, and leisure was the most common reason for daily use. Almost all participants reported searching internet for health-related information including their psychiatric diagnosis. The most common purpose, for health in-general, was searching for alternate therapies. Most common purpose for psychiatric diagnosis was understanding the symptoms, recovery from their illness, and side effects of medicines. Highest impact as perceived by the participants was on distraction or stress reduction rather than direct impact on the illness/treatment.
    Conclusion: Persons with depressive and anxiety disorders use internet for distraction, communication, and seeking information about the illness and medicines.
    Language English
    Publishing date 2023-05-19
    Publishing country India
    Document type Journal Article
    ZDB-ID 2580355-4
    ISSN 0976-2795 ; 0972-6748
    ISSN (online) 0976-2795
    ISSN 0972-6748
    DOI 10.4103/ipj.ipj_55_22
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  9. Article: Opaque hemithorax - An interesting case.

    Chawla, Rakesh K / Chawla, Aditya K / Chaudhary, Gaurav / Chawla, Madhav K / Sareen, Manoj

    The Indian journal of tuberculosis

    2021  Volume 68, Issue 3, Page(s) 420–424

    Abstract: Objective: To present an interesting case of left opaque hemithorax in an adult female and discuss its assessment and management.: Methods: Design: Case Report.: Setting: Tertiary care hospital.: Patient: One.: Results: 44yrs retropositive ... ...

    Abstract Objective: To present an interesting case of left opaque hemithorax in an adult female and discuss its assessment and management.
    Methods: Design: Case Report.
    Setting: Tertiary care hospital.
    Patient: One.
    Results: 44yrs retropositive female admitted with complaints of acute onset dry cough since 15-20 days, sudden breathlesness since 5 days which was progressive in nature, left sided heaviness in chest since 5 days. CECT Thorax showed complete collapse of left lung with cut off of left main bronchus while video bronchoscopy showed left main bronchus completely blocked with very thick necrotic mass and was difficult to dislodge. Debulking with cryo probe was done and left main bronchus was completely cleared off. Allergen panel showed very high serum IgE, high S.IgE against aspergillus and high specific S.IgG against aspergillus. Patient and her Chest X-ray showed significant improvement post cryo debulking and was discharged satisfactorily on oral voriconazole therapy.
    Conclusion: Endobronchial aspergillosis is characterized by massive intrabronchial overgrowth of the aspergillus species, mainly aspergillus fumigatus. Most patients with chronic pulmonary aspergillosis, including those with simple aspergillomas and Aspergillus nodules, have positive Aspergillus IgG antibodies in the blood. We hereby present a case of 44 yrs female presenting with complaints of dry cough and dyspnea and was diagnosed with endobronchial aspergillosis with complete obliteration of left main bronchus by fungal debris in which cryo debulking was done which relieved the symptoms significantly and was discharged in satisfactory condition on oral voriconazole therapy.
    MeSH term(s) Adult ; Antifungal Agents/administration & dosage ; Aspergillosis, Allergic Bronchopulmonary/diagnosis ; Aspergillosis, Allergic Bronchopulmonary/drug therapy ; Aspergillosis, Allergic Bronchopulmonary/physiopathology ; Aspergillosis, Allergic Bronchopulmonary/surgery ; Aspergillus fumigatus/immunology ; Aspergillus fumigatus/isolation & purification ; Bacteriological Techniques/methods ; Bronchoscopy/methods ; Cryosurgery/methods ; Cytoreduction Surgical Procedures/methods ; Female ; Humans ; Immunoglobulin E/blood ; Radiography, Thoracic/methods ; Tomography, X-Ray Computed/methods ; Treatment Outcome ; Voriconazole/administration & dosage
    Chemical Substances Antifungal Agents ; Immunoglobulin E (37341-29-0) ; Voriconazole (JFU09I87TR)
    Language English
    Publishing date 2021-01-02
    Publishing country India
    Document type Case Reports ; Journal Article
    ZDB-ID 603129-8
    ISSN 0019-5707 ; 0019-5705
    ISSN 0019-5707 ; 0019-5705
    DOI 10.1016/j.ijtb.2020.12.007
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  10. Article ; Online: Relationship of Month-Wise COVID-19 National Statistics to Pediatric Psychiatric Emergencies Presenting at a Tertiary Care Center.

    Sen, Mahadev Singh / Deep, Raman / Chawla, Nishtha / Sagar, Rajesh / Chadda, Rakesh K

    Indian journal of pediatrics

    2022  Volume 89, Issue 9, Page(s) 931

    MeSH term(s) COVID-19/epidemiology ; Child ; Emergencies ; Emergency Service, Hospital ; Humans ; Mental Disorders/diagnosis ; Mental Disorders/epidemiology ; Retrospective Studies ; Tertiary Care Centers
    Language English
    Publishing date 2022-07-12
    Publishing country India
    Document type Letter
    ZDB-ID 218231-2
    ISSN 0973-7693 ; 0019-5456
    ISSN (online) 0973-7693
    ISSN 0019-5456
    DOI 10.1007/s12098-022-04285-y
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