Mahatma Gandhi Medical College
Mahatma Gandhi Medical College
Sharma D.,Consultant Neonatologist |
Shastri S.,P.A. College |
Sharma P.,Mahatma Gandhi Medical College
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2017
Background: Lactoferrin (LF) is present in breast milk and have numerous properties including antimicrobial, antiviral, antifungal, and anticancer. Recent studies have emphasized the role of LF in neonatal care Aims and objective: To evaluate the various roles of LF in neonatal care in preterm infants. Search methods: The literature search was done for this systematic review by searching the electronic database namely Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, Scopus, Index Copernicus, African Index Medicus (AIM), Thomson Reuters (ESCI), Chemical Abstracts Service (CAS), SCIWIN (Scientific World Index), Google Scholar, Latin American and Caribbean Health Sciences Information System (LILACS), Index Medicus for the Eastern Mediterranean Region (IMEMR), Index Medicus for the South-East Asian Region (IMSEAR), Western Pacific Region Index Medicus (WPRIM), various sites for ongoing trials namely clinical trial registry (www.clinicaltrials.gov, www.controlled-trials.com, Australian and New Zealand Clinical Trials Registry (http://www.anzctr.org.au), Indian Clinical Trials Registry (http://ctri.nic.in/Clinicaltrials), and the World Health Organization (WHO) International Clinical Trials Registry, and Platform (http://www.who.int/ictrp/search/en/) and abstracts of conferences namely proceedings of Pediatric Academic Societies (American Pediatric Society, Society for Pediatric Research, and European Society for Pediatric Research). Results: Nine eligible studies were analyzed that fulfilled the inclusion criteria of the systematic review. Six duplicate publications were excluded from review. Four studies were excluded due to nonfulfillment of inclusion criteria. All of the studies had more than one outcome of interest. Four studies showed reduction in late onset sepsis (LOS), one showed reduction in invasive fungal infection (IFI), three showed significant decrease in incidence of necrotizing enterocolitis (NEC), one showed reduction in NEC scares, and two showed decrease in mortality, and one showed decrease in combined death and/or NEC. Only one study evaluated role of LF for ventilator-associated pneumonia (VAP) reduction and showed lower rate of VAP. Still the role of LF in Bronchopulmonary dysplasia (BPD) and Retinopathy of prematurity (ROP) is unclear. Conclusion: LF has shown to be promising agent for reduction of LOS and NEC. The role of LF in prevention of neonatal mortality, BPD, and ROP needs further studies. The trials that are going on around the world may be able to give reply of this question in future. © 2016 Informa UK Limited, trading as Taylor & Francis Group.
Sharma D.,Consultant Neonatologist |
Sharma P.,Mahatma Gandhi Medical College |
Shastri S.,P.A. College
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2017
Intrauterine growth restriction (IUGR) is defined as growth of fetus below its in-utero growth potential. Small for gestational age (SGA) is defined as newborn with birth weight less than 10th centile as per the gestational age, sex and race. There exists major difference between IUGR and SGA. IUGR infants have multiple short-term and long-term complications and IUGR is a silent cause of various morbidities and mortalities in these infants. IUGR/SGA is usually end results of maternal, placental, fetal and genetic causes. With the advance of molecular biology, the list genetic cause of IUGR is increasing and these genetic causes include maternal, placental and fetal genes. Several metabolic and endocrinal causes are also responsible to cause IUGR. In this review, we will try to cover genetic, metabolic and endocrinal factors that are responsible for IUGR. © 2016 Informa UK Limited, trading as Taylor & Francis Group.
Upadhyaya P.,Mahatma Gandhi Medical College |
Seth V.,Mahatma Gandhi Medical College |
Ahmad M.,Mahatma Gandhi Medical College
African Journal of Pharmacy and Pharmacology | Year: 2010
Alzheimer's disease is a devastating neurodegenerative disorder manifested by deterioration in memory and cognition, impairment in performing activities of daily living, and many behavioral and neuropsychiatric illnesses. The pathological hallmark of Alzheimer's disease is widespread neuritic plaques which are accumulations of amyloid beta protein and neurofibrillary tangles. Studies report that deficit in cholinergic system is responsible for cognitive decline and memory loss in patients with Alzheimer's disease. Various pharmacologic approaches are developed for the treatment of Alzheimer's disease. The leading edge therapies of Alzheimer's disease are approved drugs; Acetylcholinesterase inhibitors and NMDA receptor antagonist. The experimental therapies are mostly disease modifying and have neuroprotective approaches. Gamma secretase inhibitors aim to reduce amyloid beta formation. Antioxidants, antiinflammatory agents and statins help by preventing oxidation and inflammation. PPAR gamma agonists, estrogen, heavy metal chelators, 5HT 6 antagonists and nicotinic receptor agonists are other therapeutic strategies likely to alter the current treatment paradigm of Alzheimer's disease. The behavioral abnormalities are best treated first by non-pharmacologic interventions. The pharmacological agents used for treatment of Neuropsychiatric illnesses include antipsychotics, antidepressants and mood stabilizers. Treatment of Alzheimer's disease also includes health maintenance activities and proper nursing care of the patients. © 2010 Academic Journals.
Sharma K.,Mahatma Gandhi Medical College |
Jain P.,Rajasthan Dental College |
Sharma A.,Rajasthan Dental College
Indian Journal of Pharmacology | Year: 2015
Objectives: This study aimed to identify the current knowledge, attitude, and perception (KAP) of the future prescribers about antimicrobial (AM) education so that the identified lacunae in the training curriculum can be effectively addressed. Materials and Methods: A questionnaire-based survey was carried out in the 2nd year students of medical and the dental undergraduate (UG) courses at a tertiary care teaching center in Jaipur. Each respondent completed the given questionnaire independently in the allocated time. A scoring system was used to rate the KAP of the respondents as poor, average, or good. Results: Statistically significant differences were found in the KAP of the medical and dental future prescribers (P = 0.0086, 0.0002, and <0.0001 for the KAP, respectively). Conclusion: The attitude of the UG students towards AM education is good, but the deficiencies in the knowledge and perception need to be improved further. Suitable interventions to address these lacunae must be planned. © 2015 Indian Journal of Pharmacology Published by Wolters Kluwer.
Sharma B.S.,SMS Medical College |
Gupta M.K.,Mahatma Gandhi Medical College |
Chandel R.,SMS Medical College
Indian Pediatrics | Year: 2012
A cross sectional survey of 3321 school going children (5-15 years) using modified ISAAC questionnaire in Jaipur city showed 7.59% children to have asthma (in last 12 months) and 8.4% wheezing in last 12 months. Only 5.3 % children had "physician diagnosed asthma ever" suggesting under diagnoses.
Bharadwaj A.,Mahatma Gandhi Medical College |
Khandelwal M.,SMS Medical College |
Bhargava S.K.,SK Soni Manipal Hospital
Indian Journal of Anaesthesia | Year: 2014
Paediatric patients undergoing surgical procedures commonly require some volume of blood or blood component replacement in the perioperative period. Paediatric patients undergoing major surgery associated with substantial blood loss should be evaluated pre-operatively. Pre-operative correction of anaemia may be done considering the age, plasma volume status, clinical status and comorbidities. Maximum allowable blood loss (MABL) for surgery must be calculated, and appropriate quantity of blood and blood components should be arranged. Intraoperative monitoring of blood loss should be done, and volume of transfusion should be calculated in a protocol based manner considering the volemia and the trigger threshold for transfusion for the patient and the MABL. Early haemostasis should be achieved by judicious administration of red blood cells, blood components and pharmacological agents. © 2014, Indian Society of Anaesthetists. All rights reserved.
Yadav D.,SMS Medical College |
Gupta M.,Mahatma Gandhi Medical College |
Mishra S.,SMS Medical College |
Sharma P.,All India Institute of Medical Sciences
Clinica Chimica Acta | Year: 2013
Objective: Lipid profile parameters are influenced by various factors like age, ethnicity, diet, genetic and gender differences hence it is essential to establish reference range of the values of serum lipids for a given population in India. We have planned this study to evaluate the reference values of lipid profile of a North Indian population according to the guidelines of the National Cholesterol Education Program (NCEP) of the USA. Design and methods: The present study was conducted on 2021 apparently healthy individuals of North Indian origin ranging in age from 15 to 60. years, who were selected randomly using defined criteria. Fasting samples were analyzed for total cholesterol, triglyceride, HDL-C and LDL-C. Data were analyzed for middle 95th percentile (2.5th-97.5th percentile), median and 95% confidence interval using SPSS software package version 10.0. Results: No substantial difference could be observed between male and female and vegetarian and non-vegetarian, in cholesterol, triglyceride and LDL-C levels. However HDL-C reported higher limit in female as compared to male (33-64 vs 32-58. mg/dl). Similarly upper limit of HDL-C in vegetarians were higher than non-vegetarian (value 32.8-64.92 vs 30.72-58.10. mg/dl). Median value for cholesterol, triglyceride, LDL-C progressively increased in different age groups (< 20, 20-40 and 41-60. years). No marked difference was observed in reference interval of these parameters in rural and urban populations. Conclusion: It can be suggested that lipid values obtained in this study can be used as the reference value, based on which clinical correlation can be made. © 2013.
Sharma A.,Mahatma Gandhi Medical College |
Mittal R.S.,Sawai Man Singh Medical College
Journal of Neurosciences in Rural Practice | Year: 2016
Cavernous malformations (CMs) are vascular anomalies with dilated spaces called caverns. These spaces are lined by endothelial cells and collage and devoid of smooth muscle or intervening neural tissue, and filled with blood at various stages of stasis, thrombosis, organization, and calcification. Most CMs are relatively small in size but when they are large enough they can produce sing of mass effect and may simulate neoplastic, vascular, inflammatory pathology. Giant CM (size >6 cm) are very rare lesions and very few cases are reported in world literature. We are reporting such a rare case of a 16 year male. Our case is also unique in the sense that it is the largest reported CM in Indian population. © 2016 Journal of Neurosciences in Rural Practice.
Gavaskar A.S.,Mahatma Gandhi Medical College |
Achimuthu R.,Government of Tamilnadu
Journal of Spinal Disorders and Techniques | Year: 2010
Study Design: Prospective, nonrandomised, single center. Objective: To study the clinico-radiologic and functional outcome after transfacetal screw fixation and fusion for low-grade degenerative spondylolisthesis of the lumbar spine. Summary of Background Data: Surgery for degenerative spondylolisthesis conventionally involves instrumented fusion using 3 column pedicle screw fixation systems. Recently transfacetal fusion techniques have been reported to produce good results without the surgical morbidity associated with posterolateral fusion and the neurologic complications associated with pedicle screw fixation. Methods: 30 patients with low-grade degenerative spondylolisthesis of the lumbar and lumbosacral spine underwent transfacetal fusion using 2 cortical screws and local cancellous bone grafts. Results: Clinical and radiologic evidence of fusion was obtained in 29 patients. One patient developed pseudoarthrosis with progression of slip and was reoperated. Quadruple visual analog scores and Oswestry disability assessment showed a significant improvement at 1-year follow-up. Conclusions: Degenerative spondylolisthesis with lower grade slips and normal anterior structures represent an ideal indication for transfacetal fusion. This is a simple and useful technique for short segment fusions of the lumbar spine. Copyright © 2010 by Lippincott Williams & Wilkins.
Sinha P.,Mahatma Gandhi Medical College |
Gupta S.,Mahatma Gandhi Medical College |
Dawra R.,Mahatma Gandhi Medical College |
Rijhawan P.,Mahatma Gandhi Medical College
Indian Journal of Medical Microbiology | Year: 2014
Background: Scrub typhus usually affects previously healthy active persons and if undiagnosed or diagnosed late, may prove to be life-threatening. Diagnosis of scrub typhus should be largely based on a high index of suspicion and careful clinical, laboratory and epidemiological evaluation. Objective: To describe the diverse clinical and laboratory manifestations of scrub typhus diagnosed in Mahatma Gandhi Medical College and Hospital, Jaipur. Materials and Methods: All cases of febrile illness diagnosed as scrub typhus over a period of 3 months were analysed. Diagnosis was based on ELISA test for antibody detection against 56 kDa antigen. Results: Forty-two cases of scrub typhus were seen over a period of 3 months (October, 2012-December, 2012). Common symptoms were high grade fever of 4-30 days duration, cough, haemoptysis and breathlessness. Eschar was not seen even in a single patient. Liver enzymes were elevated in nearly all cases (95.9%). Multiple organ dysfunction syndrome (MODS) was present in 16.66% of our patients (7 out of 42). Hypotension (6 patients, 14.2%), renal impairment (9 out of 15 patients, 60%), acute respiratory distress syndrome (4 patients, 9.52%) and meningitis (4 patients, 9.52%) were some of the important complications. There was a dramatic response to doxycycline in nearly all the patients, but initially when the disease was not diagnosed, seven patients had died. Conclusion: Scrub typhus has emerged as an important cause of febrile illness in Jaipur. Empirical treatment with doxycycline is justified in endemic areas.