Gorakhpur, India
Gorakhpur, India

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Background. Many studies depict that pulmonary tuberculosis in a patient with type 2 diabetes mellitus (T2DM) have some different and specific presentations. Aims and objective. Present study was performed to observe the various presentations in a patient with tuberculosis and T2DM. Materials and methods. The study was performed on 105 patients with and without T2DM and sputum positive for tuberculosis divided into tuberculosis and diabetes mellitus (TBDM) group (55 patients) and tuberculosis without T2DM (TB) group (50 patients). Results were analyzed using detailed clinical history, systemic examination, radiological examination (classified in eleven patterns) and sputum smear examination (grading was done). Results. The mean age of TBDM group was 51.2 ± 8.05 and the group was older than patients in TB group where mean age was 39.5 ± 9.2 years. Duration of T2DM ranged from 6 month to 10 years, with mean 4.21 ± 1.86 years. Hemoptysis was present in 40% of patients of TBDM group. Six (12%) in TB group and 23 (41.8%) patients in TBDM group were having 3+ grade sputum smear positivity. Conclusion. Significant difference was found in presentations in patients of TB with T2DM as compared to patients without T2DM.


Pandey P.C.,Indian Institute of Technology BHU Varanasi | Pandey G.,BRD Medical College | Narayan R.J.,North Carolina State University
Biointerphases | Year: 2017

Mesoporous silica nanoparticles (MSNPs) have been used as an efficient and safe carrier for drug delivery and biocatalysis. The surface modification of MSNPs using suitable reagents may provide a robust framework in which two or more components can be incorporated to give multifunctional capabilities (e.g., synthesis of noble metal nanoparticles within mesoporous architecture along with loading of a bioactive molecule). In this study, the authors reported on a new synthetic route for the synthesis of gold nanoparticles (AuNPs) within (1) unmodified MSNPs and (2) 3-trihydroxysilylpropyl methylphosphonate-modified MSNPs. A cationic polymer, polyethylenimine (PEI), and formaldehyde were used to mediate synthetic incorporation of AuNPs within MSNPs. The AuNPs incorporated within the mesoporous matrix were characterized by transmission electron microscopy, energy dispersive x-ray analysis, and high-resolution scanning electron microscopy. PEI in the presence of formaldehyde enabled synthetic incorporation of AuNPs in both unmodified and modified MSNPs. The use of unmodified MSNPs was associated with an increase in the polycrystalline structure of the AuNPs within the MSNPs. The AuNPs within modified MSNPs showed better catalytic activity than those within unmodified MSNPs. MSNPs with an average size of 200 nm and with a pore size of 4-6 nm were used for synthetic insertion of AuNPs. It was found that the PEI coating enabled AuNPs synthesis within the mesopores in the presence of formaldehyde or tetrahydrofuran hydroperoxide at a temperature between 10 and 25 °C or at 60 °C in the absence of organic reducing agents. The as-made AuNP-inserted MSNPs exhibited enhanced catalytic activity. For example, these materials enabled rapid catalytic oxidation of the o-dianisidine substrate to produce a colored solution in proportion to the amount of H2O2 generated as a function of glucose oxidase-catalyzed oxidation of glucose; a linear concentration range from 80 to 800 μM and a detection limit as low as 80 μM were observed. The mesoscale pores of the as developed AuNP-inserted MSNPs were also used to entrap the hydrophobic drug paclitaxel. The results of this study indicate the potential use of the AuNP-inserted MSNPs in biocatalysis and drug delivery. © 2017 American Vacuum Society.


Singh K.,Child Nutrition and Development Programme | Badgaiyan N.,Child Nutrition and Development Programme | Ranjan A.,Child Nutrition and Development Programme | Dixit H.O.,National Rural Health Mission | And 3 more authors.
Indian Pediatrics | Year: 2014

Objective: To assess the effectiveness of facility-based care for children with severe acute malnutrition (SAM) in Nutrition Rehabilitation Centers (NRC). Design: Review of data. Setting: 12 NRCs in Uttar Pradesh, India. Participants: Children admitted to NRCs (Jan 1, 2010 - Dec 31, 2011). Intervention: Detection and treatment of SAM with locally-adapted protocols. Outcomes: Survival, default, discharge, and recovery rates. Results: 54.6% of the total 1,229 children admitted were boys, 81.6% were in the age group 6-23 months old, 86% belonged to scheduled tribes, scheduled castes, or other backward castes, and 42% had edema or medical complications. Of the 1,181 program exits, 14 (1.2%) children died, 657 (47.2%) children defaulted, and 610 (51.7%) children were discharged The average (SD) weight gain was 12.1 (7.3) g/kg body weight/day and the average (SD) length of stay was 13.2 (5.6) days. 206 (46.8%) children were discharged after recovery (weight gain ≥15%) while 324 (53.2%) were discharged, non-recovered (weight gain <15%) Conclusions: NRCs provide life-saving care for children with SAM; however, the protocols and therapeutic foods currently used need to be improved to ensure the full recovery of all children admitted. © 2014 Indian Academy of Pediatrics.


Sarkari N.B.S.,Brd Medical College | Thacker A.K.,Brd Medical College | Barthwal S.P.,Mln Medical College | Mishra V.K.,Brd Medical College | And 3 more authors.
Journal of Neurology | Year: 2012

Japanese encephalitis (JE) is numerically the most important global cause of encephalitis and so far confirmed to have caused major epidemics in India. Most of the reported studies have been in children. This largest study involving only adults, belonging to four epidemics, is being reported from Gorakhpur. The aim of this study is to detail the acute clinical profile (not viral) outcome and to classify the sequelae at discharge. This prospective study involved 1,282 adult patients initially diagnosed as JE admitted during the epidemics of 1978, 1980, 1988, and 1989, on identical clinical presentation and CSF examination. In the meantime, the diagnosis of JE was confirmed by serological and/or virological studies in only a representative number of samples (649 of 1,282 cases). Eightythree left against medical advice (LAMA) at various stages, so 1,199 of 1,282 were available for the study. Peak incidence of [1,061 of 1,282 (83%)] of clinically suspected cases was from September 15 to November 2. Serum IgM and IgG were positive in high titers in 50.87% (330 of 649) and IgM positive in CSF in 88.75% (109 of 123) of the cases. JE virus could be isolated from CSF and brain tissue in 5 of 5 and 4 of 5 samples, respectively. Altered sensorium (AS) in (96%), convulsions (86%), and headache (85%) were the main symptoms for hospitalization by the third day of the onset. Other neurological features included hyperkinetic movements in 593 of 1,282 (46%)-choreoathetoid in 490 (83%) and bizarre, ill-defined in 103 (17%). The features of brain stem involvement consisted of opsoclonus (20%), gaze palsies (16%), and pupillary changes (48%) with waxing and waning character. Cerebellar signs were distinctly absent. Dystonia and decerebrate rigidity was observed in 43 and 6%, respectively, paralytic features in 17% and seizures in 30%. Many nonneurological features of prognostic importance included abnormal breathing patterns (ABP) (45%), pulmonary edema (PO) (33%), and upper gastrointestinal hemorrhage (UGIH) (16%). Injection dexamethasone was used in 1978 in all 208 cases, including 21 of PO. Patients were later randomized alternately in dexa and non-dexa groups. Forty-six cases of PO from the non-dexa group were transferred to the dexa group as an ultimate life-saving measure. Thus, it was administered in 737 of 1,199 patients including 529 patients from the later epidemics in doses of 4 mg IV every 8 h for 7 days. Of 1,199, 462 did not receive it. There was no significant difference in mortality (p>0.05) between the dexa (42.47%) and the non-dexa group (42.86%). All PO cases expired; so after the exclusion of the PO cases from dexa group, the difference of 6.14% (42.86 and 36.72) became significant (p < 0.01) (511 of 1,199 (43%) expired, [320 of 511 (63%) died within 3 days of hospitalization]). Out of a total of 1,199 patients treated, 688 (57%) were discharged; 23 of 688 (3%) without any sequelae and 665 of 688 (97%) with neuropsychiatric deficits classified into nine groups. During the four epidemics, the diagnosis of JE was basically on identical clinical presentation of acute encephalitic syndrome (AES) consisting of (1) abrupt onset of fever, headache, and AS, (2) dystonias and various movement disorders, (3) opsoclonus and gaze palsies, (4) CSF findings, and (5) the presence of residual neuropsychiatric and neurological features in the survivors. © Springer-Verlag 2011.


Sarkari N.B.S.,Brd Medical College | Thacker A.K.,Brd Medical College | Barthwal S.P.,Mln Medical College | Mishra V.K.,Brd Medical College | And 3 more authors.
Journal of Neurology | Year: 2012

Japanese encephalitis, the commonest Arbovirus encephalitis, has been endemic in many parts of Asia, the Pacific Islands, and India; also, there have been many epidemics. Most of the post JE cases have been associated with neurological and neuropsychiatric deficits but have not been properly classified and followed. Practically all the previous studies were in children or young adults. The aim of this study, involving only adult cases, the largest ever being reported, has been to follow the 688/1,199 survivors of JE patients out of 1,282 of acute cases admitted during four epidemics for a period of 14 years after properly classifying the sequelae. This prospective study was conducted in B.R.D. Medical College Gorakhpur (India), involving 665/688 post JE cases with neuropsychiatric deficits from four epidemics of 1978, 1980, 1988 and 1989 which were properly classified in nine groups. While the first epidemic of 1978 was being studied, more disastrous episodes flared up and the patients were subsequently added. Hence, the total duration of this prospective study was from November 1978 to December 2003. There were 14 defaulted initially from 688 followed (23/688 without sequelae and 665/688 with neuropsychiatric deficits), and later 130 were lost from time to time at various stages of follow up. Four out of 23/688 discharged without any deficit had to be readmitted for bizarre movements, assaultative behaviour and euphoria without fever and altered sensorium. All of them improved by symptomatic treatment. Progressive improvement occurred in all the parameters consisting of psychological disturbances, higher cerebral dysfunction, speech disorders (dysphonia, dysarthria, dysphasias, apraxia and agnosia), extra pyramidal, pyramidal features, and hypothalamic disturbances, cranial nerves including pupils and fundi and seizures. Maximum cases improved between 6 months (55%) to 1 year (78%). Only some features improved between 5 to 14 years. Four patients of hemiplegia remained bed ridden. Some non disabling features like dysarthria and corticospinal features without paralysis persisted in 5% (95% improved) and 74% (26% improved) respectively. One patient with bizarre movement and nine with marked tremors could not regain normalcy. A large number of patients of JE are left with several minor or gross residual neuropsychiatric and neurological features after the acute phase. In this series also the discharged patients with neurological deficits who were quite disabled initially and needed constant care by family members and also those who required some help intermittently improved with passage of time and eventually returned to normal life. Some of them were left with non-disabling residual neurological signs even after 14 years. Fourteen of 544 (3%) could not return to their livelihood. © 2011 Springer-Verlag.


Poonam T.,Pharmacy U.T.U | Prem Prakash G.,Brd Medical College | Vijay Kumar L.,Sagar Herbal and Research Center
American Journal of Pharmacology and Toxicology | Year: 2013

Now a day's people use herb or herbal remedies along with their medication in long term treatment of various disease. Concomitant use of herb and drug can interact with each other may cause herb drug interaction. The present study was designed to investigate the possible herb drug interaction between Momordica Chrantia Fruit Juice (MCFJ) and metformin. Metformin was given orally in two different doses of 50 mg kg-1 and 100 mg kg-1. Momordica chrantia fruit juice was administered at a dose of 20 mL kg-1. The Blood glucose was estimated at 0, 7, 14, 21 and 28 days. Body weight of the rats of all the groups was recorded before and after the study period of 28 days. All the treatment shows significant (p<0.01) hypoglycemic effect. The hypoglycemic effect observed with combination of metformin and MCFJ was more than either drug alone. MCFJ alone or also in combination with metformin improve the body weight of diabetic rats. It is concluded that MCFJ along with metformin produce synergistic effect which may be beneficial or harmful so patients should take care when taking MCFJ along with metformin. © 2013 Science Publication.


Poonam T.,U.T.U. | Prakash G.P.,Brd Medical College | Kumar L.V.,Sagar Herbal and Research Center
Drug Metabolism and Drug Interactions | Year: 2013

Background: The use of herbs with allopathic medicines increases the possibility of herb-drug interaction, which may either be beneficial or harmful. Therefore, the present study was undertaken to determine the interaction of glibenclamide, a sulfonylurea, with the aqueous extract of garlic (Allium sativum), an herb used widely as an antidiabetic agent. Methods: The interaction was evaluated by an acute study, chronic study, oral glucose tolerance test, and body weight estimation in streptozotocin-induced diabetic rats. Glibenclamide was given orally at two different doses of 0.25 and 0.5 mg/kg, and A. sativum extract (ASE) was administered at the dose of 500 mg/kg. Blood glucose level and body weight estimation were carried out at various intervals. Results: The hypoglycemic effect observed with combinations of glibenclamide and ASE was greater than either of the drug given alone. Combined treatments of glibenclamide and ASE resulted in higher increase in body weight than alone treatments. Conclusions: We conclude that ASE shows a synergistic effect with glibenclamide. This could be important in reducing the dose of glibenclamide to achieve an enhanced therapeutic effect with minimal side effects.


Abrar S.,BRD Medical College | Ansari M.J.,BRD Medical College
Asian Pacific Journal of Tropical Disease | Year: 2016

Dengue is one of the most important mosquito-borne viral diseases in the world. Of note, a variety of cardiac complications have been reported in dengue-affected patients. We reported a 5-year-old boy who presented with fulminant viral myocarditis due to dengue infection and died within 24 h. Biopsy of heart revealed lymphocytic infiltration. © 2016 Asian Pacific Tropical Medicine Press.


Sondhi S.M.,Indian Institute of Technology Roorkee | Singh J.,Indian Institute of Technology Roorkee | Rani R.,Indian Institute of Technology Roorkee | Gupta P.P.,BRD Medical College | And 2 more authors.
European Journal of Medicinal Chemistry | Year: 2010

Condensation of 9-chloro-2,4-(un)substituted acridines (1a-c) with various amines (2a-e) and 9-isothiocyanato-2,4-(un)substituted acridines (4a,b) with different amines (2a,b,d,e) gave condensed products 3a-o and 5a-g respectively. Compounds 3a-o and 5a-g were screened for anti-inflammatory activity at a dose of 50 mg/kg p.o. Compound 3e exhibited 41.17% anti-inflammatory activity which is better than most commonly used standard drug ibuprofen which showed 39% anti-inflammatory (at 50 mg/kg p.o.) activity. Anticancer activity evaluation of compounds 3a-o and 5a-g was carried out against a small panel of human cancer cell lines and compounds 3g, 3m and 5g exhibited good anticancer activity against breast (MCF-7), liver (HEP-2), colon (COLO-205, 502713, HCT-15), lung (A-549) and neuroblastoma (IMR-32) cancer cell lines at a concentration of 1 × 10-5 M. © 2009 Elsevier Masson SAS. All rights reserved.


Singh Y.,BRD Medical College
Rawal Medical Journal | Year: 2012

Multiple Small bowel diverticula is an uncommon entity, the disease is usually asymptomatic and often diagnosed when complicated. A triad of epigastric pain, abdominal discomfort and flatulence one or two hours after meal (Edwards triad) are presenting features. The diagnosis must be considered in a patient with unexplained malabsorption and anemia with Edwards triad.

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