Institute of Human Behaviour and Allied science

Delhi, India

Institute of Human Behaviour and Allied science

Delhi, India
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Dung Dung A.A.,Institute of Human Behaviour and Allied science | Panda A.K.,BLK Super Speciality Hospital
BMJ Case Reports | Year: 2014

On the basis of evidence from clinical trials, contraindications to the use of interferon (INF) are pregnancy, epilepsy and depression. Management of multiple sclerosis during pregnancy is a difficult issue because of pregnancy-related complications and fear of congenital anomalies due to exposure to diseasemodifying therapy. In different series, INF therapy was withdrawn before or after variable periods of exposure. This case illustrates a 26-year-old woman diagnosed with relapsing remitting multiple sclerosis who was treated with a weekly regimen of intramuscular INF-β 1a (Avonex). She had received this treatment throughout her pregnancy without any further exacerbations of symptoms or any untoward pregnancy-related complications. In contrast to different series, our patient had the longest exposure to INF-β during pregnancy. Copyright 2014 BMJ Publishing Group. All rights reserved.

Saxena P.,Institute of Human Behaviour and Allied science
Indian pediatrics | Year: 2016

OBJECTIVE: To compare the effect of withholding maintenance phenobarbitone on breakthrough seizures.DESIGN: A double blind randomized controlled trial.SETTING: Level II neonatal intensive care unit (NICU) of a teaching hospital in Northern India.PARTICIPANTS: 152 term and near term neonates (34 weeks of gestation age) with admission weight ≥2 kg with clinically apparent seizures who received intravenous (IV) loading dose of 20 mg/kg of phenobarbitone.INTERVENTIONS: After 12 hours of seizure free period of the initial loading dose of phenobarbitone, one group received IV maintenance therapy and other 'no maintenance' (saline as placebo).MAIN OUTCOME MEASURE: Breakthrough seizures from randomization till discharge.RESULTS: Baseline variables were comparable in the two groups. Breakthrough seizures occurred in 30 (40%) subjects in placebo group and 24 (31.2%) in phenobarbitone group with RR (95% CI) of 1.28 (0.83-1.97) (P=0.19). Seizure recurrence, re-hospitali-sation, mortality and abnormal neurological assessment until 3 months were comparable in the two groups (P>0.05). Babies in either group with breakthrough seizures were more likely to be neurologically abnormal at 1 month than babies who did not have breakthrough seizures, but this difference decreased by 3 months.CONCLUSION: In term and near-term neonates, those who respond to loading dose of phenobarbitone after a single seizure episode, withholding of phenobarbitone maintenance may not significantly increase the risk of breakthrough seizures.

Gourie-Devi M.,Institute of Human Behaviour and Allied science
Neurology India | Year: 2010

Tuberculous meningitis (TBM) is a serious meningitic infection commonly found to occur in the developing countries endemic to tuberculosis. Based on the clinical features alone, the diagnosis of TBM can neither be made nor excluded with certainty. Unfortunately there is still no single diagnostic method that is both sufficiently rapid and sensitive. Most factors found to correlate with poor outcome can be directly traced to the stage of the disease at the time of diagnosis. The only way to reduce the mortality and morbidity is by early diagnosis and timely recognition of complications and institution of the appropriate treatment strategies.

Agarwal R.,Institute of Human Behaviour and Allied science | Tripathi C.B.,Institute of Human Behaviour and Allied science
International Journal of Alzheimer's Disease | Year: 2011

CSF tau and Aβ 42 are considered as important markers to diagnose Alzheimers disease in early stages. Hence, it is important to assess their status in different types of dementia. The main objective of this study was to assess whether these CSF biomarkers can be used to make the differential diagnosis of AD. In the present study, articles published from 1998 till 2009 were taken and meta-analysis was performed to clarify the consistency in trends of biomarkers- CSF tau and Aβ 42 in AD and other dementias and whether the same can be used as diagnostic biomarkers for its early diagnosis. 11 out of 60 for CSF tau and 07 out of 40 for CSF Aβ 42, dementia case-control studies were selected for final analysis. Descriptive statistics shows that median effect size (raw mean difference) of CSF tau was 429pg/mL (range: 32 to 910pg/mL) in AD whereas in Dementia due to other causes (DOC) studies it was 69pg/mL (range: -53 to 518pg/mL). Similarly the median effect size of CSF Aβ 42 levels was -442pg/mL (range: -652 to -41.200pg/mL) whereas in DOC studies it was -193pg/mL (range: -356 to -33pg/mL). © 2011 Rachna Agarwal and Chandra Bhushan Tripathi.

Nalini A.,National Institute of Mental Health and Neuro Sciences | Gourie-Devi M.,Institute of Human Behaviour and Allied science | Thennarasu K.,National Institute of Mental Health and Neuro Sciences | Ramalingaiah A.H.,Interventional Imaging
Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration | Year: 2014

Our objective was to study the clinical characteristics and natural history of monomelic amyotrophy (MMA). We used a retrospective study of 279 patients diagnosed to have either upper (Hirayama disease) or lower limb MMA. Results showed that brachial MMA (BMMA) occurred in 224 patients (male:female, 9:1). Mean age of onset was 19.5 ± 4.18 years. Progression occurred over less than five years in the majority (95.9%) of patients. Duration at the last follow-up was: up to five years in 61.4%, 5-10 in 21.3%, 10-15 in 7.2%, > 15 years in 10.1%. MRI showed asymmetrical lower cervical cord atrophy in 44.6% of patients. Crural MMA (CMMA) occurred in 55 patients (male:female, 13:1). Mean age of onset was 21.38 ± 5.3 years. Similar to BMMA, most cases (65.5%) had onset between 15 and 25 years of age. Total duration of illness at the last follow-up was up to five years in 52.7%, 10 and beyond in 47.3%. In conclusion, a large cohort of patients with monomelic amyotrophy seen over 35 years (1976-2010) is described. Study data support the clinical findings and its natural history with long term follow-up, and the findings emphasize that monomelic amyotrophy is a 'benign' condition with a self-limiting course. © 2014 Informa Healthcare.

Agarwal R.,Institute of Human Behaviour and Allied science
Indian Journal of Clinical Biochemistry | Year: 2013

Laboratories have a major impact on patient safety as 80-90 % of all the diagnosis are made on the basis of laboratory tests. Laboratory errors have a reported frequency of 0.012-0.6 % of all test results. Patient safety is a managerial issue which can be enhanced by implementing active system to identify and monitor quality failures. This can be facilitated by reactive method which includes incident reporting followed by root cause analysis. This leads to identification and correction of weaknesses in policies and procedures in the system. Another way is proactive method like Failure Mode and Effect Analysis. In this focus is on entire examination process, anticipating major adverse events and pre-emptively prevent them from occurring. It is used for prospective risk analysis of high-risk processes to reduce the chance of errors in the laboratory and other patient care areas. © 2013 Association of Clinical Biochemists of India.

Singh N.K.,Institute of Human Behaviour and Allied science | Banerjee B.D.,University of Delhi | Bala K.,Institute of Human Behaviour and Allied science | Basu M.,Institute of Nuclear Medicine and Allied Sciences | Chhillar N.,Institute of Human Behaviour and Allied science
Journal of Geriatric Psychiatry and Neurology | Year: 2014

Objectives: It has been assumed that the association between Alzheimer disease (AD) and pesticides may be stronger among genetically susceptible individuals. The aim of the study was to examine the genetic polymorphism in cytochrome P450 2D6 (CYP2D6) and glutathione S-transferases pi 1 (GSTP1) with respect to organochlorine pesticides (OCPs) and metals in AD. Methods: This study included 100 patients with AD and 100 age-matched controls. The genetic polymorphisms were analyzed by restriction fragment length polymorphism. The OCPs and serum metal levels were determined using gas chromatography and an autoanalyzer, respectively. Results: We found a statistically significant association between AD and high levels of b-hexachlorocyclohexane (b-HCH; odds ratio [OR] = 2.064, 95% confidence intervals [95% CIs] = 1.373-3.102, dieldrin [OR = 2.086, 95% CI = 1.224-3.555], and copper [OR = 1.038, 95% CI = 1.012-1.064). The significant low level of magnesium (OR = 0.151, 95% CI = 0.047-0.489) even appears to have a protective role against AD. The GSTP17*increase in AD risk. Conclusion: This study demonstrates that the GSTP1*B and *C allelic variants may be considered a candidate gene for AD. It can be suggested that although CYP2D6*4 polymorphism is not a risk of AD, the CYP2D6*4 and GSTP1 polymorphism may interact with b-HCH, dieldrin, and copper to influence the risk of AD. © The Author(s) 2014.

Talwar P.,CSIR - Central Electrochemical Research Institute | Silla Y.,CSIR - Central Electrochemical Research Institute | Grover S.,CSIR - Central Electrochemical Research Institute | Gupta M.,CSIR - Central Electrochemical Research Institute | And 3 more authors.
BMC Genomics | Year: 2014

Background: Alzheimer's disease (AD) is one of the leading genetically complex and heterogeneous disorder that is influenced by both genetic and environmental factors. The underlying risk factors remain largely unclear for this heterogeneous disorder. In recent years, high throughput methodologies, such as genome-wide linkage analysis (GWL), genome-wide association (GWA) studies, and genome-wide expression profiling (GWE), have led to the identification of several candidate genes associated with AD. However, due to lack of consistency within their findings, an integrative approach is warranted. Here, we have designed a rank based gene prioritization approach involving convergent analysis of multi-dimensional data and protein-protein interaction (PPI) network modelling.Results: Our approach employs integration of three different AD datasets- GWL,GWA and GWE to identify overlapping candidate genes ranked using a novel cumulative rank score (SR) based method followed by prioritization using clusters derived from PPI network. SR for each gene is calculated by addition of rank assigned to individual gene based on either p value or score in three datasets. This analysis yielded 108 plausible AD genes. Network modelling by creating PPI using proteins encoded by these genes and their direct interactors resulted in a layered network of 640 proteins. Clustering of these proteins further helped us in identifying 6 significant clusters with 7 proteins (EGFR, ACTB, CDC2, IRAK1, APOE, ABCA1 and AMPH) forming the central hub nodes. Functional annotation of 108 genes revealed their role in several biological activities such as neurogenesis, regulation of MAP kinase activity, response to calcium ion, endocytosis paralleling the AD specific attributes. Finally, 3 potential biochemical biomarkers were found from the overlap of 108 AD proteins with proteins from CSF and plasma proteome. EGFR and ACTB were found to be the two most significant AD risk genes.Conclusions: With the assumption that common genetic signals obtained from different methodological platforms might serve as robust AD risk markers than candidates identified using single dimension approach, here we demonstrated an integrated genomic convergence approach for disease candidate gene prioritization from heterogeneous data sources linked to AD. © 2014 Talwar et al.; licensee BioMed Central Ltd.

Pandey S.,Institute of Human Behaviour and Allied science
Journal of Spinal Cord Medicine | Year: 2011

Background: Tabes dorsalis is a late manifestation of untreated syphilis that is characterized by ataxia, lancinating pains, and urinary incontinence. A form of tertiary syphilis or neurosyphilis, it is the result of slow, progressive degeneration of the nerve cells in the spinal cord. Method: Case report. Findings: A 39-year-old man presented with tingling paresthesia in the lower limbs, difficulty in walking, and loss of vision. Magnetic resonance imaging (MRI) of the dorsal spine showed intramedullary hyperintensity and cord atrophy, similar to changes seen in subacute combined degeneration. MRI features of tabes dorsalis have not been described previously to the best of our knowledge. Conclusion: MRI findings in this patient with tabes dorsalis were similar to those seen in subacute combined degeneration, which is characterized predominantly by cord atrophy and intramedullary hyperintensities. © The Academy of Spinal Cord Injury Professionals, Inc. 2011.

Goyal R.,Institute of Human Behaviour and Allied science | Kaur N.,Institute of Human Behaviour and Allied science | Thakur R.,Institute of Human Behaviour and Allied science
Journal of Infection in Developing Countries | Year: 2011

Shewanella soft tissue infections usually occur in immunocompromised patients with a preexisting cutaneous ulcer, mostly after exposure to a marine environment or contaminated water. A 35-year-old male presented with a non-healing ulcer over the distal end of his right leg but had no predisposing factors. Cultures of exudates from the wound grew Shewanella on repeated occasions. Recovery was uneventful following surgical debridement and antimicrobial therapy. Early suspicion, diagnosis, and treatment with potent antibiotics are needed to prevent any further complications resulting from infection by this emerging pathogen. © 2011 Goyal et al.

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