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Viradiya K.,Hm Patel Center for medical Care and education | Mishra A.,Hm Patel Center for medical Care and education
Journal of Association of Physicians of India | Year: 2011

Imidacloprid is newer systemic insecticide, a nicotine analogue, acts on the nervous system. Patient can present with variable manifestations like irritability, labored breathing, emaciation, twitching and delirium. Here we report a case presented with sever neuropsychiatric symptoms with respiratory failure following self ingestion of poison. Patient recovered with supportive and symptomatic treatment. Source

Upadhyay T.R.,Hm Patel Center for medical Care and education | Kothari N.,Pacific Medical College and Hospital | Shah H.,Hm Patel Center for medical Care and education
Journal of Clinical and Diagnostic Research | Year: 2016

Introduction: Type-2 Diabetes Mellitus (T2DM) and metformin both can lower serum B12 (s.B12). Raised serum Homocysteine (s.Hcy) is considered as an early marker of B12 deficiency. Aim: The study aimed to check whether homocysteine levels are more sensitive indicator of s. B12 deficiency or not among diabetics using metformin. Materials and Methods: Mean s.B12 and s.Hcy levels of 30 cases (diabetics on metformin <5years) were compared with 30 diabetic controls not on metformin and 31 nondiabetic controls and statistically analysed by ANOVA and post-hoc tests. Results: No significant differences in either s.B12 mean or s.Hcy mean were found between cases and diabetic controls. s.B12 mean did not differ significantly but s.Hcy mean was significantly higher among nondiabetics as compared to diabetic control. s. B12 level of Nondiabetic group was in borderline category while mean s. B12 levels of cases and diabetic control groups was in normal category but nearer to the lower cut off. Mean s.Hcy values in all the groups were high. Pearson correlation showed strong association between s.B12 and s.Hcy in all the groups. Additionally equation based on linear regression was derived to calculate either of the s.B12 or s.Hcy. On Receiver Operative Characteristic (ROC) curve, area under curve value was 0.842 for the value of s.Hcy. Conclusion: In this study neither metformin nor T2DM could be identified as a cause for s.B12 lowering and raised s.Hcy in the scenario of low normal levels of s.B12 (<300pmol/L). If B12 deficiency recognized early using s. Hcy, consequences due to B12 deficiency can be prevented or delayed among nondiabetics as well as among diabetics and metformin users. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved. Source

Marwah S.A.,Hm Patel Center for medical Care and education | Shah H.,Hm Patel Center for medical Care and education | Chauhan K.,Hm Patel Center for medical Care and education | Trivedi A.,Hm Patel Center for medical Care and education | Haridas N.,Hm Patel Center for medical Care and education
Indian Journal of Clinical Biochemistry | Year: 2014

Currently employed markers for the detection of acute coronary syndrome are Troponin T, CK (Creatine Kinase) and CKMB activity. CKMB activity measured by immunoinhibition method can give falsely elevated results due to the presence of atypical CK and CKBB and at times lead to the mis-diagnosis of acute coronary syndrome. Hence, CKMB mass (CKMB) measured by electrochemiluminence sandwich principle was employed. In this cross-sectional study 183 samples of 61 patients were analyzed within 6 h of diagnosis of acute coronary syndrome and followed up to 72 h. The correlation coefficient between CKMB activity and CKMBM at 4-6 h was 0.744, while at 12-24 h it was 0.909 and at 48-72 h it was 0.337. Thus there was good association between the two methods at 12-24 h but, statistically for method comparison studies and for replacing one method by another, the two methods need to be in agreement with one another. In this study the two methods are not in agreement with one another and thus analytically not replaceable. Another finding was obtained that CKMBM reached cut off levels prior to CKMB enzyme activity and hence, CKMBM is clinically better than CKMB activity to detect reinfarction. © 2013 Association of Clinical Biochemists of India. Source

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