PubMed | Nationwide Childrens Hospital, University of California at San Francisco, Government Medical College Jammu, Harvard University and BP Koirala Institute of Health science
Type: Journal Article | Journal: Annals of global health | Year: 2015
An estimated 424,000 fatal falls occur globally each year, making falls the second leading cause of unintentional injury-related deaths after road traffic injuries. More than 80% of fall-related fatalities occur in low- and middle-income countries. Data from low-income South Asian countries like Nepal are lacking, particularly at the population level. The aim of this study was to provide an estimate of fall-injury prevalence and the number of fall injury-related deaths countrywide in Nepal and to describe the epidemiology of fall injuries in Nepal at the community level.A countrywide cross-sectional study was performed in 15 of the 75 districts in Nepal using the Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey tool. The SOSAS survey gathers data in 2 sections: demographic data, including the households access to health care and recent deaths in the household, and assessment of a representative spectrum of surgical conditions, including injuries. Data was collected regarding an individuals experience of injury including road traffic injuries, falls, penetrating trauma, and burns. Data included anatomic location, timing of injury, and whether health care was sought. If health care was not sought, the reason for barrier to care was included. Descriptive statistics were used to analyze the data.Of 2695 individuals from 1350 households interviewed, 141 reported injuries secondary to falls (5.2%; 95% confidence interval [CI], 4.4%-6.1%), with a mean age of 30.7 years; 58% were male. Falls represented 37.2% of total injuries (n = 379) reported (95% CI, 32.3%-42.3%). Twelve individuals who suffered from a fall injury were unable to access surgical care (8.5%; 95% CI, 4.5%-14.4%). Reasons for barrier to care included no money for health care (n = 3), facility/personnel not available (n = 7), and fear/no trust (n = 2). Of the 80 recent deaths reported, 7 were due to fall injury (8.8%; 95% CI, 3.6%-17.2%), and patients had a mean age of 46 years (SD 22.8). Surgical care was not delivered to those who died for the following reasons: no time (n = 4), facility/personnel not available (n = 1), fear/no trust (n = 1), and no need (n = 1).The Nepal SOSAS study provides countrywide, population-based data on fall-injury prevalence in Nepal and has identified falls as a crucial public health concern. These data highlight persistent barriers to access to care for the injured and the need to improve trauma care systems in developing countries such as Nepal.
PubMed | Government Medical College Jammu
Type: Journal Article | Journal: International journal of applied & basic medical research | Year: 2015
Inflammatory myofibroblastic tumor (IMT) is a rare, aggressive tumor of indeterminate malignant potential with myofibroblastic differentiation. Though bladder location is very uncommon, it arises from the bladder submucosal stroma as a polypoidal growth and is easily mistaken for a malignant neoplasm- clinically, radiologically and histologically. Essential criteria for the diagnosis of IMT are: spindle myoepithelial cell proliferation and lymphoplasmacytic infiltrate. Here we report the case of a 30 years old man who presented with painless gross haematuria for 2 weeks. The patient underwent open partial cystectomy and the final pathological diagnosis was IMT of bladder.
Khajuria A.,Goa Institute Of Management |
Khajuria V.,Government Medical College Jammu
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2013
Pharmaceutical houses adopt numerous marketing strategies to influence physician by providing them with incentives. Present study was undertaken to evaluate the impact of these marketing promotional strategies on prescribing of drugs by physicians. 34 post graduate and 21 graduate physicians were presented a questionnaire highlighting 17 different promotional methods, adopted by pharmaceutical houses. The responses were recorded and weightage was given. The choice of physician regarding generic named or branded product was also recorded. Responses of postgraduate and graduate physicians were compared. Results revealed that Cost of product, Seminars, Publications, Brochures and Booklets and Reputation of company were the most important factors considered by the physicians while prescribing of drugs. While mailing information about products, gifts and Print and Broadcast ads were least important factors. Similar responses of post graduate and graduate doctors were observed on most of parameters. Top 9 influencing factors were found to be similar but with little variation in sequence .The study of results revealed that graduate doctors preferred generic product over branded product (57.1%) while post graduates the branded (60%).Study has provided a clear insight into the impact of pharmaceutical marketing promotional factors on physician prescribing practices. Pharmaceutical companies should mould and adapt their marketing communication strategy as per physician's response.
Wani A.A.,Government Medical College Jammu |
Jan N.,Directorate of health services Kashmir
Iranian Journal of Dermatology | Year: 2011
Background: Alopecia Areate (AA) is a recurrent non-scarring patchy hair loss of autoimmune origin in a genetically susceptible individual although environmental factors may be contributory. The aim of this study is to evaluate serum iron and ferritin levels in patients with AA. Methods: Fifty patients of AA and 50 age and sex matched control subjects without any hair loss were studied. Results: No significant difference was found in mean hemoglobin, ferritin, and iron levels in two groups. Serum iron ferritin and hemoglobin levels did not show any significant variations with respect to the extent or duration of the disease, family history, history of atopy, and nail involvement. Conclusion: In our study, the levels of serum iron and ferritin showed no significant changes in AA patients and seems not to play a role in the etiology of AA. © 2011 Iranian Society of Dermatology.
Kanotra S.P.,Government Medical College Srinagar |
Kanotra S.,Government Medical College Jammu |
Paul J.,Government Medical College Jammu |
Jamwal P.S.,Government Medical College Jammu
Ear, Nose and Throat Journal | Year: 2010
Chondrosarcoma is the most frequently encountered nonepithelial tumor of the larynx. Still, laryngeal chondrosarcoma is a rare disease, accounting for less than 1% of all laryngeal neoplasms; only about 600 cases have been reported in the world literature. The two most common sites of origin are the cricoid cartilage (69% of cases) and the thyroid cartilage (9%); arytenoid cartilage origin has been seen in less than 3% of cases. The diagnosis of laryngeal chondrosarcoma is easy to miss because of its infrequent occurrence, its indolent pattern of growth, and the difficulty in differentiating it histopathologically from chondroma. However, suspicion of arytenoid chondrosarcoma may be raised by a finding of its characteristic appearance as a smooth, hard, mucosa-covered supraglottic mass that is fairly recognizable on indirect laryngoscopy. We report a new case of chondrosarcoma of the arytenoid cartilage in a 47-year-old man, and we discuss the clinical features, diagnosis, and management of this uncommon tumor.
Gupta V.,Government Medical College Jammu |
Chopra V.,Government Medical College Jammu |
Verma S.,Government Medical College Jammu
Indian Journal of Surgery | Year: 2014
Cutaneous horn (cornu cutaneum) is a relatively uncommon lesion consisting of a projectile, conical, dense, hyperkeratotic nodule which resembles the horn of an animal. Cutaneous horns most frequently occur in sun-exposed parts and are typically found in the face and the scalp, but may also occur on the hands, eyelids, nose, chest, neck, shoulder and penis. Their occurrence on the penis is uncommon. We report a 42-year-old man presenting with penile cutaneous horn. The association with malignancy on the penis makes proper identification of these lesions essential. Standard treatment involves local excision, but the presence of malignancy mandates a partial penectomy. © 2013 Association of Surgeons of India.
Nissar A.U.,Indian Institute of Integrative Medicine |
Farrukh M.R.,Indian Institute of Integrative Medicine |
Kaiser P.J.,Indian Institute of Integrative Medicine |
Rafiq R.A.,Indian Institute of Integrative Medicine |
And 5 more authors.
Phytomedicine | Year: 2013
Aim of present study was to investigate the effect of NAC on experimental chronic hepatotoxicity models induced by carbon tetrachloride (CCl4) and thioacetamide (TAA). CCl4 toxicity was induced by administering 200 μl CCl4 (diluted 2:3 in coconut oil)/100 g body weight, p.o., twice weekly for 8 weeks. TAA toxicity was induced by administering 150 mg/kg b. wt. of TAA i.p., twice weekly for 8 weeks. NAC treatment was started along with toxicants (CCl4 and TAA) for 8 weeks and continued for further 4 weeks. Self reversal group was kept without any treatment for 4 weeks after completion of toxicant treatments. Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP), Bilirubin were measured in serum. Hydroxyproline (HP), lipid peroxidation (LPO), catalase (CAT), Glutathione peroxidase (GPx) and Glutathione (GSH) were determined in liver samples by colorimetric methods. Cytochrome P450 2E1 (CYP 450 2E1), activity was determined as hydroxylation of aniline in liver microsomes. General examination and histological analysis were also performed. Serum markers of liver damage (AST, ALT, ALP and Bilirubin) were increased by CCl4 and TAA intoxication (p < 0.001), whereas co-treatment with NAC reversed such changes (p < 0.001). HP was enhanced in toxicant groups (p < 0.001 in CCl 4 and TAA), but inhibited by NAC (p < 0.001). LPO was increased while as GSH, CAT and GPx decreased by the administration of CCl4 and TAA (p < 0.001); co-administration of NAC restored these liver markers to normal levels (p < 0.001). Biochemical determinations were corroborated by general and histological findings. Keeping in view the biochemical and histopathological studies, it was concluded that CCl4 and TAA are strong hepatotoxic agents that produce liver fibrosis with close proximity to human etiology (micronodular cirrhosis) and NAC has a significant protective activity against CCl4 and TAA. NAC has also been validated as a model against oxidative burden in chronic liver pathology. © 2013 Elsevier GmbH.
Ali N.,Government Medical College Jammu |
Sharma S.,Government Medical College Jammu |
Kamal Y.,Government Medical College Jammu
Iranian Journal of Pediatrics | Year: 2012
Background: Congenital insensitivity to pain with anhidrosis is an extremely rare disorder in which injuries can often be missed by patient, parents and even by orthopedic surgeon. Pain and tenderness, on which a trauma team so much depends to make a clinical diagnosis and to decide whether to go for radiological evaluation can be misleading in this rare syndrome. So complete clinical examination still forms the corner stone to avoid misdiagnosis and pick up the rare disorders. Case Presentation: We present a 5 year old girl child, who was brought to us as a case of one and a half month old neglected trauma left leg and was diagnosed to be suffering from congenital insensitivity to pain with anhidrosis (HSAN Type IV). Conclusion: Congenital insensitivity to pain with anhidrosis is extremely rare entity, in which patients are subjected to repeated injuries which are often neglected. There is no specific treatment but patient training and parent education are key to avoid further neglect and damage. © 2012 by Pediatrics Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, All rights reserved.
PubMed | Government Medical College Srinagar and Government Medical College Jammu
Type: Journal Article | Journal: International journal of health sciences | Year: 2016
To assess the role, efficacy and tolerability of levodopa-carbidopa in the management of small and older children with different types of amblyopia.Prospective randomised placebo controlled clinical study, in which 50 amblyopic patients between 5 and 20 years of age with visual acuity (V/A) < 20/40 were included, was carried on. After having attained the best possible refractive correction, patients were randomly divided into 2 groups. They were prescribed levodopa-carbidopa (10:1) (4-6mg/kg/day in 2-3 divided doses) or placebo, plus full-time occlusion of the sound eye, for a period of three months. Assessment of improvement in V/A, compliance and tolerance was done at follow up visits. Data was analyzed using computer software Ms-Excel and Epi-Info Version 6.0. The statistical significance was assessed by Chi-Square/Fishers Exact Test.Visual acuity for the amblyopic eye improved significantly in both groups but there was significant improvement in group 1 than group 2 (P = 0.0001). In a subgroup of patients older than 12 years, levodopa group showed statistically significant improvement in baseline V/A (P = 0.0001). In patients with severe amblyopia, each group showed significant improvement in baseline V/A (p < 0.05), but was significantly more in group 1 (P = 0.0001). Compliance rates were similar among the groups and levodopa-carbidopa at a dose range of 4-6 mg/kg/day was well tolerated.Levodopa-carbidopa can be used as an adjunct to conventional occlusion therapy in amblyopia particularly in older children and severe cases of amblyopia, and it is well tolerated.
PubMed | Government Medical College Srinagar, Registrar and Government Medical College Jammu
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2015
Acute Pancreatitis is a very common condition leading to the emergency visits in both developed and developing countries. Computed Tomography plays a pivotal role in the diagnosis and subsequent management of pancreatitis. The modified CT severity index includes a simplified assessment of pancreatic inflammation and necrosis as well as an assessment of extra pancreatic complications.To study role of modified computed tomography severity index in evaluation of acute pancreatitis and its correlation with clinical outcome.This was a hospital based prospective correlative study done on patients of all age groups referred to the Department of Radio diagnosis from the various indoor and outdoor departments of the hospital, with clinical/Laboratory/ultrasonography findings suggestive of acute pancreatitis. The severity of pancreatitis was scored using Modified CT severity index & CT severity index and classified into mild, moderate and severe categories. Total of 50 patients of acute pancreatitis presenting to the emergency department of our hospital were included in the study. Clinical outcome parameters for correlation collected from respective referral departments included, the length of hospital stay (in days), need for surgical intervention, need for percutaneous intervention (aspiration and drainage), evidence of infection in any organ system (combination of a fever > 100F and elevated WBC >15,000/ mm(3)), evidence of organ failure (PaO2 < 60 mm Hg or need of ventilation, systolic BP of < 90 mm Hg, serum creatinine of >300moles/L or urine output of < 500 ml / 24 h) and death.The age of the patients in the study group was in the range of 17 to 80 years. Maximum patients were in the age group 40-50 years (42.0%). The mean age was 42.32 years. Out of 50 cases, 33 (66%) were male and 17 (34%) were females with a male to female ratio of 2:1. Cholelithiasis was found to be most common aetiological factor for acute pancreatitis in 40% cases. Alcoholic pancreatitis was seen in 36% of cases. Together cholelithiasis and alcoholism accounted for 76% of cases. Pleural effusion was the most common extra-pancreatic complication, 28 patients (56%), followed by ascites. Majority of patients were categorized as severe pancreatitis (44%). 38% patients were grouped into moderate pancreatitis and 18% were categorized in mild pancreatitis. The outcome parameters in terms of length of hospital stay, need of intervention, development of infection, and development of organ failure were more in patients with higher modified CT severity index.In conclusion CECT was found to be an excellent imaging modality for diagnosis, establishing the extent of disease process and in grading its severity. The Modified CT Severity Index is a simpler scoring tool and more accurate than the Balthazar CT Severity Index. In this study, it had a stronger statistical correlation with the clinical outcome, be it the length of hospital stay, development of infection, occurrence of organ failure and overall mortality. It could also predict the need for interventional procedures.