Sharma P.,Chirayu Medical College and Hospital
Asian Journal of Pharmaceutical and Clinical Research | Year: 2017
Bronchiectasis is a type of chronic obstructive pulmonary disease, defined as permanent abnormal dilation of bronchi due to vicious cycle of transmural infection and inflammation. Bronchiectasis is generally characterized by cough, wheeze, and dyspnea. Pathogens responsible for bronchiectasis include pathogens Haemophilus influenzae, Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus aureus, and nontuberculous mycobacteria. Empirical antibiotic therapy and other drugs are used empirically in the management of bronchiectasis.Here, we discuss a case of infectious exacerbation of bronchiectasis successfully treated with an empirical use of ceftriaxone/sulbactam/disodium edetate-1034. © 2017 The Authors.
Pandey A.,Narshinbhai Patel Dental College and Hospital |
Saxena K.,Chirayu Medical College and Hospital
Neurochemical Research | Year: 2014
Stroke is an emergency which threatens life and third leading cause of death and long term disability in developed countries. The use of biomarkers in diagnosing stroke and assessing prognosis is an emerging and rapidly evolving field. The study aimed to investigate the predictive value of biochemical marker of brain damage neuron-specific enolase (NSE) and systemic inflammatory marker C-reactive protein (CRP) with respect to degree of disability at the time of admission and short term in stroke patients. We investigated 120 patients with cerebrovascular stroke who were admitted within 72 h of onset of stroke in the Department of Neurology at Sri Aurobindo Institute of Medical Sciences, Indore, India. NSE and CRP were analyzed by solid enzyme linked immunosorbent assay using analyzer and micro plate reader from Biorad 680. In all patients, the neurological status was evaluated by a standardized neurological examination and the National Institutes of Health Stroke Scale on admission and on day 7. Serum NSE and CRP concentration were found significantly increased in acute stroke cases as compared to control in present study (<0.05 and <0.001 respectively). The maximum serum NSE and CRP levels within 72 h of admission were significantly higher in patients with greater degree of disability at the time of admission. Both biomarkers were found significantly correlated with neurological disability and short term outcome. Our study showed that serum biomarkers NSE and CRP have high predictive value for determining severity and early neurobehavioral outcome after acute stroke. © 2014 Springer Science+Business Media.
Jain A.,Chirayu Medical College and Hospital
Archives of Physiology and Biochemistry | Year: 2013
Adenosine deaminase (ADA) is an enzyme of purine salvage pathway and has two important isoenzymes ADA1 and ADA2. The activity of ADA has been changed in diseases characterized by altered cell-mediated immunity. It was observed that total serum ADA activity was decreased during normal pregnancy compared with non-pregnant women. However, total serum ADA activity and serum ADA2 activity was increased in hyperemesis gravidarum and pre-eclampsia in pregnant women. Less information is available regarding role of ADA in abortions (recurrent and missed) and anembryonic pregnancies. Here, we review the activity of ADA and its isoenzymes. Despite these findings, it will be interesting to know whether activity of ADA will be same if ADA is estimated throughout the pregnancy and in pregnancy related complications from early first trimester to third trimester, as all studies until now were carried out at a particular stage of pregnancy. © 2013 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.
Kataria B.C.,C U Shah Medical College |
Bhavsar V.H.,Chirayu Medical College and Hospital
Asian Journal of Pharmaceutical and Clinical Research | Year: 2012
Objective: There is a change in the regulatory environment after a system of product patents in India since 2005. The objective of this study was to analyse the trends of drug approval in India during the period of 1999 to 2011. Materials and Methods: The information about drug approvals was primarily obtained from the Indian regulatory agency website. For the drug products identified, the drugs were classified into fourteen main Anatomical Therapeutic Chemical (ATC) groups, single or combination products, types of dosage form, approvals for additional strength, approvals for additional indication and approvals for new dosage form. Results: We identified 1506 approvals by the DCGI from 1999 to 2011, with a mean of 115.84±83.24 (SD) approvals per year (Median approvals per year: 79; Range: 23-264). The ATC groups containing over 10% of total approvals were N (nervous system), with 232 (15.4%); J (antiinfective for systemic use), with 204 (13.54%); A (alimentary tract and metabolism), with 192 (12.74%) and C (cardiovascular system), with 186 (12.35%). Since 2004, there is a rising trend for approval of products having drugs in combination. Total 448 new drugs were approved during the period of 1999 to 2011, with a mean of 34.46±8.14 (SD) new drug approvals per year (Median new drug approvals per year: 36; Range: 22-53). Conclusions: These results show that there is a rising trend of approval for fixed dose combinations. The pattern of 'new drug' approval was flattened around the years when patent policy change was introduced.
Agrawal A.,Chirayu Medical College and Hospital |
Singh V.K.,Escorts Heart Institute and Research Center |
Varma A.,Escorts Heart Institute and Research Center |
Sharma R.,Escorts Heart Institute and Research Center
Indian Pediatrics | Year: 2012
Context: Reports of successful use of vasopressin in various shock states and cardiac arrest has lead to the emergence of vasopressin therapy as a potentially major advancement in the management of critically ill children. Objective: To provide an overview of physiology of vasopressin, rationale of its use and dose schedule in different disease states with special focus on recent advances in the therapeutic applications of vasopressin. Data Source: MEDLINE search (1966-September 2011) using terms "vasopressin", "terlipressin", "arginine-vasopressin", "shock", "septic shock", "vasodilatory shock", "cardiac arrest", and "resuscitation" for reports on vasopressin/ terlipressin use in children and manual review of article bibliographies. Search was restricted to human studies. Randomized controlled trials, cohort studies, evaluation studies, case series, and case reports on vasopressin/terlipressin use in children (preterm neonates to 21 years of age) were included. Outcome measures were analysed using following clinical questions: indication, dose and duration of vasopressin/terlipressin use, main effects especially on systemic blood pressure, catecholamine requirement, urine output, serum lactate, adverse effects, and mortality. Results: 51 reports on vasopressin (30 reports) and terlipressin (21 reports) use in pediatric population were identified. A total of 602 patients received vasopressin/terlipressin as vasopressors in various catecholamine-resistant states (septic - 176, post-cardiotomy - 136, other vasodilatory/mixed shock - 199, and cardiac arrest - 101). Commonly reported responses include rapid improvement in systemic blood pressure, decline in concurrent catecholamine requirement, and increase in urine output; despite these effects, the mortality rates remained high. Conclusion: In view of the limited clinical experience, and paucity of randomized controlled trials evaluating these drugs in pediatric population, currently no definitive recommendations on vasopressin/terlipressin use can be laid down. Nevertheless, available clinical data supports the use of vasopressin in critically ill children as a rescue therapy in refractory shock and cardiac arrest.
Vishwakarma N.,Chirayu Medical College and Hospital
Nepal Medical College journal : NMCJ | Year: 2011
Teeth are well preserved after death and they exhibit remarkable sexual dimorphism. Hence, they provide excellent materials for forensic investigations intended for identification of sex. Present study was undertaken on permanent mandibular canines of 90 male and 90 female subjects of age group 17-23 years. The mesiodistal width for right and left mandibular canines and intercanine distance were measured. Subsequently, canine index was calculated for both sides. Significant sexual dimorphism was found in all parameters except intercanine distance. All the results were compared with previous studies and discussed in the light of genetic, evolutionary and metabolic reasons for sexual dimporhism.
Das S.,Mahatma Gandhi Institute |
Narang P.,Mahatma Gandhi Institute |
Nagamiah S.,National Tuberculosis Institute |
Mishra P.S.,Mahatma Gandhi Institute |
And 3 more authors.
International Journal of Tuberculosis and Lung Disease | Year: 2015
BACKGROUND: Ziehl-Neelsen (ZN) staining requires heating, and pre-stained smears contain viable bacilli. OBJECTIVE: To evaluate four variants of carbol fuchsin solution by the pot method and compare the results with ZN staining, taking culture as gold standard. METHOD: Five hundred sputum samples from presumptive tuberculosis cases were homogenised and divided into two parts. One part was subjected to routine ZN staining and culture on solid medium, the other was equally distributed into four pots. Equal quantities of the basic fuchsin (BF) variant were added to each pot. Variant I contained 2% BF with 10% phenol and 4% ammonium sulphate (PhAS), while Variant II had 0.6% BF with PhAS; Variants III and IV contained respectively 2% and 0.6% BF with 10% phenol only. After 1 h, smears were made from each pot and culture was performed on Löwenstein-Jensen medium. Smear results were compared with the ZN results and evaluated against culture. RESULTS AND CONCLUSION: Variant III gave excellent results compared to ZN (κ = 0.97), with sensitivity, specificity, and positive and negative predictive values similar to those of ZN, taking culture as gold standard. Pot contents were negative for Mycobacterium tuberculosis culture. © 2015 The Union.
Kapre M.,Neeti Clinics |
Mangalgiri A.S.,Chirayu Medical College and Hospital
Indian Journal of Otolaryngology and Head and Neck Surgery | Year: 2012
Duplication of internal jugular vein (IJV) is rare. It is the larger channel draining the cranial cavity. We encountered duplication of the IJV while cervical node clearance in a patient with squamous cell carcinoma of left margin of the tongue. IJV divides into two parts anterior and posterior after descending about 2.5 cm from the jugular foramen. IJV is an important landmark in neck surgery. Knowledge of its variations is essential to avoid complications during surgery and to avoid misinterpretation in CT angiography. © 2011 Association of Otolaryngologists of India.
Kanhere A.V.,Chirayu Medical College and Hospital |
Kanhere V.M.,Chirayu Medical College and Hospital
Journal of Obstetrics and Gynecology of India | Year: 2016
Heart disease is one of the common, indirect obstetric causes of maternal death. Management of these cases may challenge the entire team providing care to the mother and fetus. Advances in cardiac surgery has improved quality of life and level of functioning of cardiovascular system of patients with congenital or acquired heart disease. These diseases complicate 0.1–4 % pregnancies. Maternal complications in the form of thromboembolic, hemorrhagic episode and heart failure may occur. The fetus is in danger of effects of oral anticoagulation therapy and other medications given to the patient in order to support cardiovascular system, intrauterine growth restriction and danger of hypoxia. In recent era, we are facing more pregnant patients with previous history of surgical correction of congenital or rheumatic heart disease. In this review, we have attempted to draw a management protocol of such patients based on the available literature and various international guidelines. In pregnant women with mechanical heart valves, recent data support warfarin use throughout pregnancy, followed by a switch to heparin and planned induction of labor. However, the complexity of this situation demands a cafeteria approach where the patient herself can choose from the available options that are supported by evidence-based information. Preconception counseling, evaluation and antenatal high-risk management protocol with the help of cardiologist and cardiac surgeon improves maternal and neonatal outcome. © 2016, Federation of Obstetric & Gynecological Societies of India.
Agrawal A.,Chirayu Medical College and Hospital |
Goyal S.,Chirayu Medical College and Hospital
Indian Pediatrics | Year: 2012
Acute demyelinating encephalomyelitis usually follows viral infections and its occurrence following malarial infection is very uncommon. We report a 12-year-old girl who presented with encephalopathy and generalized convulsions following complete recovery from the Plasmodium falciparum infection. Diagnosis of ADEM was made on the basis of brain MRI findings. © 2012 Indian Academy of Pediatrics.