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Bohidar N.P.,Rabindranath Tagore International Institute of Cardiac science | Krishna K.,Bharati Vidyapeeth Medical College and Hospital | Panda B.K.,Bharati Vidyapeeth Deemed University | Patel C.,Bharati Vidyapeeth Deemed University
Tropical gastroenterology : official journal of the Digestive Diseases Foundation

Preclinical studies have found ilaprazole to be significantly effective in preventing the development of reflux oesophagitis and gastric secretion in a dose-dependent manner; the drug also has a broad dose range and safety feature. Till date only one clinical study on patients with gastro-oesophageal reflux disease has shown its potency in suppressing gastric acid secretion. To review the published randomized controlled trials (RCTs) assessing the efficacy of ilaprazole in duodenal ulcer (DU) compared to other available proton pump inhibitors (PPI). RCTs comparing ilaprazole with other PPIs in DU were searched in the PubMed and Cochrane Library database using the term 'ilaprazole and duodenal ulcer'. All clinical studies showing effectiveness of ilaprazole in patients with DU, either full texts or scientific abstracts and found to be potentially eligible for the systematic review, were included and evaluated. Four RCTs having follow-up data were included. A total of 1077 patients with DU were assessed. All the trials had included omeprazole as a comparator PPI. The majority of patients (80%) became asymptomatic after treatment in both the groups. None of the trials data predict ilaprazole to be superior to omeprazole in terms of efficacy in patients with DU. The trials conducted were limited in numbers and all the trial data indicated the efficacy of ilaprazole to be similar to that of omeprazole. None of the trials indicated superiority of ilaprazole over the existing PPIs. Source

Namjoshi G.S.,MSD Pharmaceuticals Pvt Ltd | Mitra M.,Institute of Child Health | Lalwani S.K.,Bharati Vidyapeeth Medical College and Hospital | Sachdeva A.,Sir Gangaram Hospital | And 6 more authors.

Burden of rotavirus gastroenteritis (RVGE) in outpatient setting in India is not fully understood. A prospective study was undertaken to describe RVGE among Indian children less than 5 years of age presenting in outpatient departments with acute gastroenteritis (AGE). This study was conducted at 11 outpatient departments (OPDs) of private pediatric clinics in urban areas of India. A total of 605 eligible children were enrolled at OPDs. Stool samples of the subjects were collected and tested for presence of rotavirus antigen by enzyme immune assay (EIA) and were typed by reverse-transcriptase polymerase chain reaction (RT-PCR). Physician examined the children and documented the disease particulars. In addition, parents/guardians were interviewed for AGE related symptoms, health care utilization and cost incurred due to AGE, and parental stress associated with AGE. After OPD, parents/guardians completed diary cards and questionnaires to capture the information for 14 days following the enrollment. Complete data for analysis including stool sample results was available from 552 subjects. 23% (127/552; [CI 19.5, 26.5]) of stool samples were rotavirus (RV) positive. RT-PCR was done for 85.8% (109/127) of RV positive samples. G1, G2, G9, and G12 types were identified in 34.9% (38/109), 37.6% (41/109), 8.3% (9/109), and 6.4% (7/109) stool samples, respectively. P[4] and P[8] were identified in 36.7% (40/109) stool samples each, followed by P[6] identified in 15.6% (17/109) stool samples. At the time of enrollment, all three symptoms (vomiting, diarrhea, and fever) were observed concurrently in higher proportion of RV positive subjects compared to RV negative subjects (60.6% [77/127] vs. 42.8% [182/425], p= 0.0004). Healthcare resource utilization, costs incurred due to disease, and parental stress were higher for RV positive subjects compared to RV negative subjects. In conclusion, RVGE was found to be a definite burden in AGE cases attending pediatric outpatient clinics in urban areas and it was associated with substantial economic and psychological burden. Introduction of rotavirus vaccine in India may help in reducing this disease burden. © 2014. Source

Pawar H.J.,Pravara Institute of Medical Sciences | Singh K.K.,Pravara Institute of Medical Sciences | Dhumale G.B.,Bharati Vidyapeeth Medical College and Hospital
Journal of Krishna Institute of Medical Sciences University

Background: The 'organ distribution' of cancer is often strikingly dissimilar in different groups of population and varies greatly from one community to another and also differs in different communities in the same geographical location, depending on the practices, lifestyles and the influence of deleterious habits like use of tobacco and or alcohol of the people. Among various cancers affecting the human body, oral cancer accounts for nearly one third of it. Objectives: i) To find out the relative frequency of oral cancer in relation to other sites from Hospital Based Cancer Registry (HBCR) ii) To find out the various risk factors associated with oral cancer and iii) To recommend appropriate preventive measures. Methodology: A hospital based retrospective cross sectional study was conducted through case records of oral cancer patients who reported in the year 2013 to Pravara Rural HBCR, Department of Radiotherapy and Oncology, Rural Medical College and Pravara Rural Hospital, Loni, Maharashtra state, India. The case files and registers of oral cancer cases were reviewed to collect personal and clinical data about sex, age, occupation, marital status, education, socioeconomic status, habits like tobacco chewing and cigarette smoking. A predesigned performa (a core form by HBCR programme) was used to collect the data. The statistical analysis was done using SYSTAT for Windows version 12 and categorical data was analysed by using Chi-square test. Results: In all1328 patients of all cancers visited the hospital during the period January 2013 to December 2013. Out of these, 349 (26.28%) were of oral cancer cases. The sex wise distribution revealed 256 (73.25%) among males and 93(26.65%) among females. Mean age of the patients was 54.98 years, ranging from 15- 78 years, 31.23% were more than 65 years of age. The most oral cancer sites among the males and females were those of tongue (37.82%) and buccal mucosa (32.95%) respectively. Tobacco related cancer patients in males were 79% and in females 61%.Conclusion: The present study findings suggest that prevalence of oral cancer is more among tobacco users especially those using tobacco quid which is more common among Indian women which is in line with most of the epidemiological studies about oral cancer in India. There is an urgent need to implement and sustain appropriate preventive measures and oral cancer screening programmes for the community. © Journal of Krishna Institute of Medical Sciences University Source

Jain P.,National Institute of Virology | Varanasi G.,National Institute of Virology | Ghuge R.,National Institute of Virology | Kalrao V.,Bharati Vidyapeeth Medical College and Hospital | And 4 more authors.
Indian Pediatrics

Objective: To characterize rotavirus infections detected in rotavirus vaccinated children hospitalized for acute gastroenteritis. Design: Observational, hospital-based study. Setting: Three hospitals in Pune, Western India. Participants: Children aged <5 years hospitalized for acute gastroenteritis during 2013-14. Methods: Rotavirus capture ELISA was performed on all stool samples that were collected from patients following informed consent from parents. VP7 and VP4 genes of rotavirus strains were genotyped by multiplex RT-PCR. Stool samples from vaccinated children were tested for other enteric viruses. Results: Among the 529 children, 53 were vaccinated with at least one dose of the rotavirus vaccine. There was no difference in the mean (SD) (months) age of vaccinated [14.8 (10.6)] and unvaccinated [14.4 (10.5)] children. Rotavirus positivity was significantly higher (47%) in unvaccinated than in vaccinated (28.3%) children (P=0.01). Mean Vesikari score and severe cases were significantly more in rotavirus positive than in negative children within unvaccinated group (P<0.001), while these did not differ within the vaccinated group. Rotavirus strain G1P[8] was identified as the most prevalent strain in both, vaccinated (60%) and unvaccinated (72.8%) groups. No association was found between mean Vesikari score and viral coinfections. Conclusions: This study suggests decline in rotavirus positivity in rotavirus-vaccinated children hospitalized for acute gastroenteritis and high prevalence of G1P[8] and non-rotaviral co-infections in Pune, Western India. © 2016, Indian Academy of Pediatrics. Source

Jadhav S.,Bharati Vidyapeeth Medical College and Hospital | Oswal J.,Bharati Vidyapeeth Medical College and Hospital
Journal of Krishna Institute of Medical Sciences University

Munchausen Syndrome By Proxy (MSBP) is an extremely complicated diagnosis because of the difficulty in finding the incriminating evidence of its existence and because of the ethical issue it raises for caregivers. Its implications from a medical, psychological and legal point of view raise difficult questions for any professional confronted to it. We present a case of 8 month female infant who was diagnosed to have Hyperinsulinism causing hypoglycemic brain injury and later developing intractable convulsion with head drops, where EEG was suggestive of West Syndrome, was actually a case of Munchausen syndrome by proxy to start with. © Journal of Krishna Institute of Medical Sciences University. Source

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