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Allahābād, India

Duseja A.,Jawaharlal Institute of Postgraduate Medical Education & Research | Singh S.P.,SCB Medical College | Saraswat V.A.,Sanjay Gandhi Post Graduate Institute of Medical Sciences | Acharya S.K.,All India Institute of Medical Sciences | And 12 more authors.
Journal of Clinical and Experimental Hepatology

Non-alcoholic fatty liver disease (NAFLD) is closely associated with metabolic syndrome. Prevalence of metabolic risk factors including diabetes mellitus, obesity, etc. is rapidly increasing in India putting this population at risk for NAFLD. Patients with NAFLD are at increased risk for liver-related morbidity and mortality and also cardiovascular disease risk and increased incidence of diabetes mellitus on long-term follow-up. Management of patients with NAFLD may require a multi-disciplinary approach involving not only the hepatologists but also the internists, cardiologists, and endocrinologists. This position paper which is a combined effort of the Indian National Association for Study of the Liver (INASL), Endocrine Society of India (ESI), Indian College of Cardiology (ICC) and the Indian Society of Gastroenterology (ISG) defines the spectrum of NAFLD and the association of NAFLD with insulin resistance and metabolic syndrome besides suggesting preferred approaches for the diagnosis and management of patients with NAFLD in the Indian context. © 2015 INASL. Source

Chakraborty A.,MotiLal Nehru Medical College | Adhikari P.,Mangalore University | Shenoy S.,Mangalore University | Saralaya V.,Mangalore University
Indian Journal of Pathology and Microbiology

Context: In recent years, nonlactose fermenting (NLF) Escherichia coli have been increasingly isolated in the microbiology laboratory, but their clinical significance has not yet been clearly elucidated. Aims: To characterize the lactose fermenting (LF) and NLF isolates on the basis of their virulence factors, phylogenetic background, and drug resistance property. Settings and Design: This descriptive study was carried out in a multi-specialty tertiary care hospital. Subjects and Methods: Three hundred nonrepeat E. coli isolates from inpatients were studied. Isolates were differentiated as LF and NLF on the basis of colony characteristics on MacConkey's agar. Possession of virulence and drug resistance genes was determined by multiplex polymerase chain reaction (PCR). Phylogenetic analysis was performed by triplex PCR methods. Antibiotic sensitivity testing was performed by disk diffusion method. Results: Of 300 isolates 39 (13%) were NLF isolates. Maximum number of NLF isolates belonged to phylogroups B2 and D when compared with LF isolates. The incidence of iutA, hlyA, and neuC genes were significantly higher in NLF isolates. The presence of drug resistance genes such as AmpC gene, SHV, and CTXM were higher in LF isolates. Conclusions: LF isolates demonstrated a higher antimicrobial resistance and NLF isolates possessed higher virulence properties. The microbiology laboratory should report lactose fermentation profile as it may help the physician to initiate appropriate treatment. © 2016 Indian Journal of Pathology and Microbiology | Published by Wolters Kluwer - Medknow. Source

Bhalerao S.A.,Regional Institute of Ophthalmology | Tandon M.,Regional Institute of Ophthalmology | Singh S.,Regional Institute of Ophthalmology | Dwivedi S.,MotiLal Nehru Medical College | And 2 more authors.
Indian Journal of Ophthalmology

Background/Aims: Information on eye diseases in blind school children in Allahabad is rare and sketchy. A cross-sectional study was performed to identify causes of blindness (BL) in blind school children with an aim to gather information on ocular morbidity in the blind schools in Allahabad and in its vicinity. Study Design and Setting: A cross-sectional study was carried out in all the four blind schools in Allahabad and its vicinity. Materials and Methods: The students in the blind schools visited were included in the study and informed consents from parents were obtained. Relevant ocular history and basic ocular examinations were carried out on the students of the blind schools. Results: A total of 90 students were examined in four schools of the blind in Allahabad and in the vicinity. The main causes of severe visual impairment and BL in the better eye of students were microphthalmos (34.44%), corneal scar (22.23%), anophthalmos (14.45%), pseudophakia (6.67%), optic nerve atrophy (6.67%), buphthalmos/glaucoma (3.33%), cryptophthalmos (2.22%), staphyloma (2.22%), cataract (2.22%), retinal dystrophy (2.22%), aphakia (1.11%), coloboma (1.11%), retinal detachment (1.11%), etc. Of these, 22 (24.44%) students had preventable causes of BL and another 12 (13.33%) students had treatable causes of BL. Conclusion: It was found that hereditary diseases, corneal scar, glaucoma and cataract were the prominent causes of BL among the students of blind schools. Almost 38% of the students had preventable or treatable causes, indicating the need of genetical counseling and focused intervention. Source

Bedre R.H.,Louisiana State University | Raj U.,Indian Institute of Information Technology Allahabad | Misra S.P.,MotiLal Nehru Medical College | Varadwaj P.K.,Indian Institute of Information Technology Allahabad
Indian Journal of Gastroenterology

Nucleotide/nucleoside analogues (antiviral therapy) are used in the therapy of HBeAg positive and HBeAg negative chronic hepatitis B. We analyzed ten selected randomized controlled with 2557 patients to estimate the effect of antiviral drugs in chronic hepatitis B with compared to placebo. Virological response, biochemical response, histological response, seroconversion of HBeAg, and loss of HBeAg were estimated as primary efficacy measures. The included studies were subjected for heterogeneity and publication bias. The heterogeneity was assessed with χ2 and I2 statistics. Publication bias was assessed by funnel plot. Greater rates of improvement obtained in antiviral group for virological response [43.96 % vs. 3.15 %, RR = 0.57, 95 % CI = 0.54–0.61, p-value <0.00001], biochemical response [58.37 % vs. 21.87 %, RR = 0.52, 95 % CI = 0.48–0.56, p-value <0.00001], histological response [58.99 % vs. 27.13 %, RR = 0.56, 95 % CI = 0.50–0.63, p-value <0.0001], seroconversion of HBeAg [10.66 % vs. 5.56 %, RR = 0.94, 95 % CI = 0.91–0.97, p-value = 0.0005], and HBeAg loss [14.59 % vs. 9.64 %, RR = 0.92, 95 % CI = 0.88–0.96, p-value = 0.0002]. The safety analysis were carried out for adverse events such as headache [17.22 % vs. 17.34 %, OR = 1.09, 95 % CI = 0.81–1.46, p-value = 0.58], abdominal pain [16.46 % vs. 14.34 %, OR = 1.24, 95 % CI = 0.90–1.72, p-value = 0.19], and pharyngitis [22.22 % vs. 18.23 %, OR = 1.12, 95 % CI = 0.86–1.45, p-value = 0.40]. Excluding adverse events, all primary efficacy measures shown statistical significant result for chronic hepatitis treatment (p-value <0.05). Antiviral therapy provided significant benefit for the treatment of chronic hepatitis B with no measurable adverse effects. © 2016, Indian Society of Gastroenterology. Source

Singh A.K.,MotiLal Nehru Medical College | Singh B.,MotiLal Nehru Medical College
Journal of the Anatomical Society of India

This cross sectional study was conducted to evaluate accuracy of commonly used ultrasound dating formulae in specified North Indian population. BPD of fetuses of 841 singleton pregnant females was ultrasonographically measured for subsequent statistical analysis.The mean BPD for each GA (derived from LMP) of this study was statistically compared with mean BPD from that of published data by Hadlock et al., Shepard & Filly, Sabbagha & Hughey and Kurtz et al.. Square Regression Equation was selected to prepare a population specific BPD table for every respective GA.The results show that North Indian fetuses are smaller than European fetuses even before 3rd trimester and gestational ages derived from sonographic Western reference equations are underestimated in this population, hence IUGR is diagnosed frequently; suggesting the need of population specific charts.It is generally thought that the small size of Indian neonates at birth is attributable to small maternal size, an inadequate nutrient supply during late pregnancy, or both; but that early fetal growth, when nutrient requirements are very small and there are no constraints on space for growth, is similar to that of other populations.This suggests that any intervention designed to ensure appropriate fetal growth in North Indian populations would need to start pre-conceptionally or during early pregnancy. © 2012 Anatomical Society of India. Source

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