Medical Institute and Research Center

Vadodara, India

Medical Institute and Research Center

Vadodara, India
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Khakhkhar T.,Gujarat Adani Institute of Medical science | Shah R.,Gujarat Medical Education and Research Society GMERS Medical College | Hemavathi K.G.,Medical Institute and Research Center
Drugs and Therapy Perspectives | Year: 2016

Introduction: Antimicrobial prophylaxis before a surgical procedure can reduce the risk of surgical site infections (SSI). The literature suggests that the greater the lag period between the first dose of antimicrobial administration and surgical incision, the greater the chances of developing an SSI. Hence, appropriate timing of the administration of prophylactic antimicrobials is critical to maximize the benefits of prophylaxis. Objective: To examine the association between the timing of prophylactic antimicrobial administration and SSI rate in a tertiary-care hospital. Methodology: A total of 200 patients undergoing elective surgery from different surgical wards were included. Their detailed history, drug use especially that of antimicrobials, and surgical site were observed daily till discharge from the hospital. Odds ratios were calculated to examine the association between the timing of prophylactic antimicrobial use and the rate of SSIs. Results: In the total population of 200 patients, 63 patients (31.5 %) received their first prophylactic antimicrobial dose within 30 min before incision, with SSIs occurring in 6 of these patients (9.5 %); 133 patients (66.5 %) received a prophylactic antimicrobial >30 min before incision, with SSIs occurring in 29 (21.8 %); and the remaining 4 (2 %) patients did not receive preoperative antimicrobials prior to incision, with SSIs occurring in 3 patients (75 %). The odds ratio of developing an SSI in patients receiving their first dose of preoperative antimicrobial >30 min before incision relative to those receiving their first dose of preoperative antimicrobial within 30 min before incision is 2.65. Conclusion: This study examines the association between the timing of antimicrobial administration before surgery and the development of SSIs. Patients who received the antimicrobial dose too early before the procedure, including cases where the surgical procedure was delayed after the antimicrobial was administered, had an increased likelihood of an SSI. Efforts to improve the timing of antimicrobial administration are needed to decrease the SSI rate. © 2016, Springer International Publishing Switzerland.

Aenumulapalli A.,Medical Institute and Research Center | Kulkarni M.M.,Medical Institute and Research Center | Gandotra A.R.,Medical Institute and Research Center
Journal of Clinical and Diagnostic Research | Year: 2017

Introduction: Flat foot (pes planus) is a commonly observed disorder in clinical practice. The height of Medial Longitudinal Arch (MLA) determines the degree of pes planus. Majority of the previous studies on prevalence of flexible flat foot were done among children. Aim: The present study was undertaken to determine the prevalence of flexible flat foot among 18-21-year-old Indian adults using Navicular Drop Test (NDT) which is regarded as reliable and valid method to characterise MLA. Materials and Methods: The present study was a cross- sectional study in which Brody’s Navicular Drop Test was performed in five hundred healthy subjects (250 males and 250 females) aged 18-21-year-old. Navicular Drop (ND) of ≥ 10 mm was regarded as flexible flat foot. Statistical analysis was done using SPSS version 23.0. Results: The prevalence of flexible flat foot was 13.6% (for males-12.8%; for females-14.4%). The median with Inter Quartile Range (IQR) for ND among males was 6 mm (4-8) and 6 mm (4-9) for right and left foot respectively. The median with IQR for ND among females was 6mm (4-10) and 7mm (3-8) for right & left respectively. The correlation of Right Side Navicular Drop (RND) with height and weight was significant, but insignificant correlation was found between RND and BMI. The correlation of Left Side Navicular Drop (LND) with height, weight and BMI of individuals was statistically not significant.The difference between the ND of males and female group was statistically not significant. Conclusion: The present study quantified the prevalence of flexible flat foot and gender wise normative values of ND among 18-21-year-old Indian adults. The information obtained by this study will be useful in field of orthopaedics. © 2017, Journal of Clinical and Diagnostic Research. All rights reserved.

Pandya H.B.,Medical Institute and Research Center | Agravat H.H.,Gujarat Adani Institute of Medical science | Patel J.S.,Gujarat University
Journal of Clinical and Diagnostic Research | Year: 2017

Introduction: Virulent markers of H. pylori, the vacuolating cytotoxin (vacA), cytotoxin-associated gene product (cagA), induced by contact with epithelium factor antigen (iceA gene) and the urease C gene (ureC) may plays a major role in determining the clinical outcome of Helicobacter infections. Aim: To detect the prevalence of the cagA, vacA, ureC and iceA genotypes of H. pylori from antral biopsy specimens of patients and to associate its role in specific disease. Materials and Methods: The study was conducted at Department of Microbiology of Shree PM Patel College of Paramedical Sciences, Anand, Gujarat, India. Seventy one antral biopsies of symptomatic patients referred for endoscopy from October 2012 to September 2013 were subjected to Multiplex PCR. DNA isolation from 71 biopsy samples was done by using “QIAamp DNA mini kit” from QIAGEN (GmbH, Hilden, Germany). Data was analysed using Chi square (χ2) test and p-value<0.05 is considered significant. Results: Out of the 71 biopsies screened, 22(31%) samples were positive for H. pylori by PCR, with high proportion of cagA positive (17/22 specimen; 77.27%), followed by ureC positive (4/22 specimen; 18.18%) and vacA positive (1/22 specimen; 4.54%) strains. Significant association was found between cagA and female gender (p-value-0.042). Out of 17 cagA positive strains, nine were causing gastritis (52.94%), five were causing reflux oesophagitis (29.41%) and three were causing duodenal ulcer (17.64%). We found 0% prevalence of iceA gene; conversely we had three peptic ulcer patients with only cagA positivity. Conclusion: The cagA positive strain mainly affects the patients with gastritis specifically of female gender and iceA genotype is not a useful marker associated with peptic ulcer disease. Patients should be screened for cagA genotype when reported to be a case of gastritis for early treatment to prevent further complications such as cancer. © 2017, Journal of Clinical and Diagnostic Research. All rights reserved.

Doshi S.M.,Medical Institute and Research Center | Doshi P.M.,P.A. College
Journal of Indian Academy of Forensic Medicine | Year: 2016

Study of age dependent morphological changes in varieties of bones is a distinguished way to justify age, especially for ages beyond thirties. This study was carried out to discover various changes at sternal rib ends of fourth ribs with special attention to the rim and wall, as well as to correlate them with the age of an individual. Special focus was given to ascertain any bilateral variability for the same. Total 170 ribs were collected from male dead bodies out of which 140 ribs belonged to 70 cases were included as study materials. Each rib was classified according to different stages of Rim and Wall morphology. The data derived were statistically analysed. It is concluded that changes of rim and wall at sternal end of fourth ribs are age dependent. With the advancing age, Rim changes from its smoothness towards the well-defined scallops formation to ill-defined scallops and Wall changes from its appearance to its increasing thickness and then towards its structural deterioration with bony projections. There is no any significant bilateral variation seen in changes of rim and wall according to age.

Agarwal S.S.,Pramukhswami Medical College and SK Hospital | Kumar L.,Medical Institute and Research Center | Chavali K.H.,All India Institute of Medical Sciences
JMS - Journal of Medical Society | Year: 2017

Sexual assault causes tremendous physical and psychological trauma in women and children. Indian law recognizes sexual violence very seriously through various sections of the Indian Penal Code, yet the conviction rate is meager. It resulted in several amendments of Penal and Criminal Procedure Codes, Evidence Act along with Protection of Children from Sexual Offenses Act. These amendments intend to broaden the focus of medical examination from mere collection of evidence to a holistic approach for complete care and rehabilitation of victims.[1] However, these amendments have landed the medical practitioners as well as the victim in conflicts of ethical and legal issue such as mandatory reporting to police even when the victim is nonconsenting; mandatory examination, treatment and rehabilitation by any medical practitioner (government and private), and that too free of cost. The present article aims to highlight such conflicting legal and ethical issues for the medical practitioners who examine and treat such victims. All the relevant and pertinent statutory laws, guidelines, and regulations were studied together from the viewpoint of rights and duties of a medical practitioner. We intend the law makers to review the acts, codes, and guidelines for clarity, leaving no space for perplexity for medical practitioners and at the same time protecting the rights of victims of sexual assault. © 2017 Journal of Medical Society.

Patel M.,Swasthya Hospital | Patel I.M.,Swasthya Hospital | Patel Y.M.,Swasthya Hospital | Rathi S.K.,Medical Institute and Research Center
Journal of Health, Population and Nutrition | Year: 2012

This cross-sectional study assessed the current situation of and factors associated with consumption of diabetic diet among 399 type 2 diabetes mellitus (T2DM) subjects from Ahmedabad, Western India. The study was performed with diagnosed (at least one year old) diabetic subjects who attended the Department of Diabetology, All India Institute of Diabetes and Research and Yash Diabetes Specialties Centre (Swasthya Hospital), Ahmedabad during July 2010-November 2010. The subjects completed an interviewer-administered questionnaire. The questionnaire included variables, such as sociodemographic factors, family history of diabetes, behavioural profile, risk profile (glycaemic status, hypertension, and obesity), and diet-related history (consumption of diabetic diet, consumption of low fat/skimmed milk, method of cooking, and sources for diet advice). Blood pressure, body mass index, glycosylated haemoglobin (HbAlc) level, and fasting lipid profile were measured. All analyses including multivariate logistic regression were conducted using SPSS, version 11.5. In total, 399 T2DM subjects (65% male, 35% female) with mean age of 53.16±7.95 years were studied. Although 73% of T2DM subjects were consuming diabetic diet, the good glycaemic control (HbAlc level <7%) was achieved only in 35% of the subjects. The majority (75%) of the subjects had a positive family history of diabetes, and 52% were obese. In 77%, the main source of dietary advice was doctor. In 36%, the main methods of cooking were: boiling and roasting. The final multivariate model showed that visit to dietician, level of education, intake of low fat, and family history of diabetes were independent predictors for diabetic diet consumption among T2DM subjects. However, longitudinal and cohort studies are required to establish the association between consumption of diabetic diet and glycaemic control.

Patel D.A.,Civil Hospital | Gupta P.A.,Civil Hospital | Kinariwala D.M.,Civil Hospital | Shah H.S.,GMERS Medical College | And 2 more authors.
Journal of Global Infectious Diseases | Year: 2012

Background: Most outbreaks of viral hepatitis in India are caused by hepatitis E. Recently in the year 2009, Modasa town of Sabarkantha district in Gujarat witnessed the outbreak of hepatitis B. Purpose: An attempt was made to study the outbreak clinically and serologically, to estimate the seropositivity of hepatitis B Virus among the cases and their contacts and to know the seroprevalence of hepatitis B envelope antigen (HBeAg) and IgM antibody against hepatitis B core antigen (IgM HBcAb) out of all the Hepatitis B surface Antigen (HBsAg) positive ones. Materials and Methods: Eight hundred and fifty-six (856) cases and 1145 contacts were evaluated for hepatitis B markers namely HBsAg, HBeAg and IgM HBcAb by enzyme-linked immuno Sorbent Assay (ELISA) test. Results: This outbreak of viral hepatitis B in Modasa, Gujarat was most likely due to unsafe injection practices. Evidence in support of this was collected by Government authorities. Most of the patients and approximately 40% of the surveyed population gave history of injections in last 1.5-6 months. Total 664/856 (77.57%) cases and 20/1145 (1.75%) contacts were found to be positive for HBsAg. 53.41% of the positive cases and 52.93% of the positive contacts were HBeAg-positive and thus in a highly infectious stage. Conclusions: Inadequately sterilized needles and syringes are an important cause of transmission of hepatitis B in India. Our data reflects the high positivity rate of a hepatitis B outbreak due to such unethical practices. There is a need to strengthen the routine surveillance system, and to organise a health education campaign targeting all health care workers including private practitioners, especially those working in rural areas, as well as the public at large, to take all possible measures to prevent this often fatal infection.

Shah P.S.,Baroda Medical College and SSG Hospital | Kataria L.,Medical Institute and Research Center
Internet Journal of Mental Health | Year: 2010

Background: Social phobia even though being a common psychiatric disorder is still under recognized and under treated. We study prevalence, severity, disability and quality of life with respect to social phobia among university students in India.Methods: A stratified sample of 380 undergraduate university students was assessed to identify the extent of social phobia, its correlates as well as resulting disability and quality of life.Results: Social phobia was found in 19.5% of participants, in varied degrees of severity and correlated with various faculties in university, resulting in significant disability in work, social life, and family life, as well as impairment in quality of life. 'Acting, performing or giving a talk in front of an audience' was the most commonly feared/avoided situation. Students reported various clinical manifestations affecting academic, social and interpersonal areas.Conclusions: High prevalence and marked impact on life demands stringent efforts to recognize and treat social phobia. Copyright Internet Scientific Publications, LLC., 1996 to 2010.

Rawal S.V.,Medical Institute and Research Center
Indian Journal of Tuberculosis | Year: 2014

Background: Tribal population resides in difficult to reach terrain. It is vital to know, in context of “Universal care approach”, whether they are equitably benefited by RNTCP. Objective: To compare RNTCP performance in tribal areas with non-tribal areas and to detect whether the difference in performance indicators is statistically significant. Methods: A comparative analysis of RNTCP performance indicators like total case detection rate, new smear positive case detection rate, etc., was carried out using annual data of last three years in tribal and non-tribal areas. T-test was applied to confirm statistically significant difference. Results: The performance of tribal area is better in terms of suspects examined per lakh population per year, total case detection rate, NSP case detection rate and success rate. The difference was close to statistically significant difference at 95% confidence limit and the difference was significant at 90% confidence limit. The extra-pulmonary case notification rate was significantly higher in non-tribal areas with understandable reasons. Conclusion: Significantly high previously treated smear positive case notification rate in tribal area is a matter of concern .The incentives to tribal areas appear to reap better results and these need to be supported and sustained. © 2014, Tuberculosis Association of India. All rights reserved.

Shah R.,Medical Institute and Research Center | Gajjar B.,Pramukhswami Medical College | Desai S.,Medical Institute and Research Center
National Journal of Physiology, Pharmacy and Pharmacology | Year: 2012

Aims & Objective: To study the adverse drug reaction profile, its causality, severity, associated risk factors and preventability in geriatric patients in a tertiary care teaching rural hospital. Materials and methods: Four hundred geriatric patients from various inpatient and outpatient departments were observed for occurrence of adverse drug events (ADEs) during August 2007 to October 2009. ADEs were either spontaneously reported or elucidated from personal interviews and analyzed. Results: In forty seven (11.75%) patients, 57 events occurred of which 75.43% occurred in indoor and 24.56% in outdoor patients. Most patients (74.46%) were in the age range of 65 to 74 years. The male to female ratio was 1.47: 1. Majority of ADEs involved gastrointestinal system (43.85%), followed by cardiovascular system (14.03%), endocrine system (12.28%) and skin and mucous membranes (12.28%). 142 drugs were suspected to cause these ADEs. Chemotherapeutic agents were the most commonly suspected drugs followed by cardiovascular drugs, drugs acting on CNS and steroids. On assessing causality, majority of events were rated as 'possible' by both WHO-UMC (66.66%) and Naranjo's criteria (68.42%). Severity assessment (Hartwig scale) showed that 19.29%, 68.42% and 12.28% ADEs were severe, moderately severe and mild respectively. Risk factors for ADR development found were socioeconomic status (p=0.000), number of diseases suffered (p=0.002), number of medicines taken per day (p=0.000), compliance (p=0.048) and inappropriate prescribing (p=0.004). 36.84% ADRs were definitely preventable and 17.54% were probably preventable by modified Schumock and Thornton scale. Conclusion: ADRs is a major problem prevalent in geriatric patients and is significantly associated with socioeconomic status, number of diseases, number of medicines consumed per day, compliance to therapy and inappropriate prescribing.

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