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Kar S.S.,Jawaharlal Institute of Postgraduate Medical Education & Research | Selvaraj K.,Pondicherry Institute of Medical science PIMS | Ramalingam A.,Maulana Azad Medical College MAMC | Roy G.,Jawaharlal Institute of Postgraduate Medical Education & Research
Australasian Medical Journal | Year: 2016

Background WHO declared Influenza A H1N1 to have entered the post pandemic phase on August 10, 2010. Continued surveillance activities are recommended in the post pandemic phase to watch over the trend, severity and impact of Influenza like illnesses (ILI). Aims This study aimed to document the epidemiological profile of lab positive H1N1 cases in post pandemic period from August 2010-December 2014 in nodal H1N1 surveillance centre of Puducherry. Methods The study analysed secondary data collected during the period August 10, 2010 to Dec 2014 from ILI suspects attending a tertiary care hospital, for the Integrated Disease Surveillance Project (IDSP). Demographic details, lab positivity based on Real-time PCR technique for H1N1, clinical symptoms and outcomes were extracted. Data were analysed using STATA version 11.0. Independent predictors of lab positivity rate were identified using logistic regression analysis. Time trend of frequency of suspected cases and lab positivity rate were performed using time series plots. Results A total of 2065 suspected cases were reported, of whom 197 cases were positive for H1N1 (lab positivity rate 9.5 per cent). Being an adult (OR: 1.6; 95 per cent CI: 1.1-2.3; p=0.02), management in in-patient settings (OR: 2.5; 95 per cent CI: 1.3-4.7; p=0.001), history of contact (OR: 2.7; 95 per cent CI: 1.5-4.5; p=0.0001) and history of travel (OR: 2.3; 95 per cent CI: 1.2-4.3; p=0.01) were the independent predictors for lab positivity. Death rate among lab confirmed cases was found to be 9.6 per cent. After 2012, the trend of laboratory confirmed H1N1 cases became a plateau. One needs to screen 35 suspected cases to capture one lab confirmed case of H1N1 in 2014. Conclusion Lab positivity was seen among 9.5 per cent of cases and the independent predictors were severe cases, adult patients, positive history of contact and travel. The number needed to screen to get one lab positive H1N1 case is 35 suspected cases. © 2016, Australasian Medical Journal Pty Ltd. All Rights reserved. Source


Bhagat S.,Maulana Azad Medical College MAMC | Agarwal M.,Maulana Azad Medical College MAMC | Roy V.,Maulana Azad Medical College MAMC
International Journal of Surgery | Year: 2013

Background: Serratiopeptidase is a proteolytic enzyme prescribed in various specialities like surgery, orthopaedics, otorhinolaryngology, gynaecology and dentistry for its anti-inflammatory, anti-edemic and analgesic effects. Some anecdotal reports suggest it to possess anti-atherosclerotic effects also, due to its fibrinolytic and caseinolytic properties. Despite being widely used there are few published studies regarding its efficacy. Thus, evidence regarding its clinical utility is needed. Objective: To evaluate the existing evidence regarding efficacy and safety of Serratiopeptidase in clinical practice. Evidence acquisition: A systematic review of all the published articles of Serratiopeptidase using Cochrane Library, PubMed, MEDLINE, Clinical Trials.gov, Google, Dogpile and a manual search of bibliographies was conducted from 1st May 2011 till 15th July 2012. Further emails were sent to all the leading pharmaceuticals who are manufacturing this enzyme preparation for any additional information. All studies related to Serratiopeptidase which included Randomised controlled trials (RCTs), meta-analysis of RCTs, placebo-controlled, single-blind, double-blind, open label, prospective trials as well as preclinical studies were screened and analysed. The scientific credibility of the studies was graded according to the Scottish Intercollegiate Guidelines Network (SIGN) grading checklist. A total of 24 studies on clinical efficacy of Serratiopeptidase met the inclusion criteria. Evidence synthesis: Serratiopeptidase search on Cochrane library revealed 16 results among which 9 were Cochrane Central Register of Controlled Trials 2011, issue 4 studies and 7 were Cochrane Central Register of Controlled trials 2012, issue 3 studies. Of these 16 results, 11 were RCTs on efficacy of Serratiopeptidase. PubMed search also revealed 74 results which showed 16 Clinical trials, out of which 9 were RCTs related to Serratiopeptidase. Bandolier online edition (retrieved on 1/5/2011) showed a review 'Serratiopeptidase-finding the evidence' which included 9 RCTs. The evidence supporting the use of Serratiopeptidase as anti-inflammatory and analgesic agent is based on clinical studies which are of poor methodology. Only few RCTs, which are usually placebo control, with a small sample size are there. The dose and duration of treatment was not specified in some studies, and the outcome of the study was not clearly defined in a few. Data on the safety and tolerability of Serratiopeptidase is lacking in these studies. Limitations: A thorough search of literature was done to include all the relevant studies but we may have unknowingly missed a few of those studies which have not been published or registered with any of these search engines. The clinical evidence obtained have been graded according to the "Scottish Intercollegiate Grading Network" checklist by two separate reviewers and then coordinated together to give the final grading. Any disagreement between the two reviewers was resolved by discussion with the third reviewer. This was done to minimise bias but still the risk of bias cannot be completely ruled out. Conclusion: Serratiopeptidase is being used in many clinical specialities for its anti-inflammatory, anti-edemic and analgesic effects. It is even being promoted as a health supplement to prevent cardiovascular morbidity. The existing scientific evidence for Serratiopeptidase is insufficient to support its use as an analgesic and health supplement. The data on long-term safety of this enzyme is lacking. Evidence based recommendations on the analgesic, anti-atherosclerotic efficacy, safety and tolerability of Serratiopeptidase are needed. © 2013 Surgical Associates Ltd. Source


Makkar B.,Maulana Azad Medical College MAMC | Batra S.,Maulana Azad Medical College MAMC | Gandhi G.,Maulana Azad Medical College MAMC | Zutshi V.,Maulana Azad Medical College MAMC | Goswami D.,Maulana Azad Medical College MAMC
Gynecologic and Obstetric Investigation | Year: 2014

Background: Unsatisfactory colposcopy, an inability to visualize the entire transformation zone, is found in about 10-20% of the patients undergoing the procedure. These patients usually require conization for a comprehensive evaluation of the cervix. Our study aims to compare the efficacy and safety of vaginal misoprostol versus vaginal estradiol in overcoming unsatisfactory colposcopy. Methods: We studied 48 women with unsatisfactory colposcopy. They were randomized into two groups: group I (n = 24) received 200 μg misoprostol vaginally and colposcopy was repeated after 6 h, while the subjects in group II (n = 24) were prescribed a 7-day course of 50 μg estradiol for vaginal insertion followed by a repeat colposcopy. The efficacy and safety of these two drugs were compared. Results: Repeat colposcopy was satisfactory in 70.8% of the women given vaginal misoprostol compared to 82.6% of the women who used vaginal estradiol. The difference was not statistically significant. The adverse effects were reported more often by the women in the misoprostol group (41.6%) as compared to those in estradiol group (13%) (p = 0.04). Conclusion: Both estradiol and misoprostol were comparable in overcoming unsatisfactory colposcopy. However, a higher incidence of adverse effects was noted with misoprostol as compared to estradiol. © 2014 S. Karger AG, Basel. Source


Patil S.J.,Maulana Azad Medical College MAMC | Pakhiddey R.,Maulana Azad Medical College MAMC | Rana K.,Maulana Azad Medical College MAMC | Kakar S.,Maulana Azad Medical College MAMC
Journal of Morphological Sciences | Year: 2013

Cystic artery is usually a branch of right hepatic artery given in the Calot's triangle. Variations in the origin of cystic artery have been previously reported. The present case report describes the origin of cystic artery from the common hepatic artery taking an unusual course, which was detected during routine dissection. These kinds of variations are expected to arise if anything goes wrong during the embryological development of biliary vasculature. An attempt has been made to discuss the surgical and embryological relevance of the reported anomaly. Source


Panda M.,Maulana Azad Medical College MAMC | Rustogi D.,Maulana Azad Medical College MAMC | Singh A.,Maulana Azad Medical College MAMC | Kapoor S.,Maulana Azad Medical College MAMC | And 2 more authors.
Indian Journal of Pediatrics | Year: 2013

Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological syndrome characterized clinically by headache, seizures, visual disturbances, vomiting and radiologically by predominant posterior leukoencephalopathy. The authors report an 11-y-old boy with meningitis presenting with transient hypertension and visual loss and MRI finding compatible with the diagnosis of PRES and complete reversal of symptomatology within 10 d. A wide plethora of tests carried out failed to identify the cause of transient hypertension with a probability of this being due to transient autonomic dysfunction. © 2012 Dr. K C Chaudhuri Foundation. Source

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