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Jaipur, India

Ahmed M.S.,Kannur Medical College | Neyaz A.N.,NIMS Medical College | Aslami A.,Travancore Medical College
Lung India

Background: Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible. It is an incurable disease with improvement in quality of life (QOL) as a major focus area for management. This study assesses the QOL of COPD patients and the factors affecting it. Materials and Methods: All 124 patients diagnosed with COPD in a larger cross-sectional study to determine the prevalence of COPD were assessed for their QOL using St. George's respiratory questionnaire for COPD patients (SGRQ-C). Spirometry was performed to assess lung function and diagnose COPD. Chronic lung disease (CLD) severity index was used to assess the severity of symptoms and the Medical Research Council questionnaire was used to assess the severity of dyspnea. Sociodemographic data regarding the patients were also recorded. Results: Patients with COPD showed significantly reduced health-related quality of life (HRQOL). CLD estimate for severity of lung disease and the Medical Research Council assessment for dyspnea and the duration of illness showed a highly significant positive correlation with HRQOL. There was a statistically significant negative correlation between lung function and SGRQ-C score. Increasing age, increased quantum of smoking, and lower socioeconomic status were correlated with poorer HRQOL. No association between QOL and education, body mass index (BMI), and gender was observed. Conclusion: This study showed that Indian patients with COPD had reduced HRQOL. Poor lung function, increased disease duration and smoking, and worsening symptoms impacted HRQOL negatively. © 2016 Indian Chest Society. Source

Moinuddin A.,NIMS Medical College | Gupta R.,Himalayan Institute of Medical science | Saxena Y.,Himalayan Institute of Medical science
Journal of Clinical and Diagnostic Research

Introduction: Globally, prehypertension is responsible for approximately 62% of cardiovascular and 49% of ischemic heart disease (IHD) episodes. Current data from the Indian subcontinent suggests that prevalence of prehypertension was 47% amongst young urban residents. Considering its serious prognosis, the current study was undertaken to assess risk factors such as for cardiovascular diseases in prehypertensives adult males in Uttarakhand region. Materials and Methods: This cross-sectional analytical study was conducted in the Department of Physiology, HIMS, Dehradun, over a period of 12 months. Volunteers (20-40 years) were divided into two groups; Group I (Controls): normotensives and Group II (Cases): prehypertensives based on JNC VII classification. Results: Exercise capacity, determined by peak VO2 consumption was significantly lower in prehypertensive group than the normotensive group (p<0.001). Daily salt intake of pre-hypertensives was significantly greater than the normotensive subjects (p<0.001). Multiple Linear Regression analysis revealed that average baseline SBP increases by 0.34 mmHg for every 1 kg increase in weight and average baseline DBP increases by 0.25 mmHg for every 1 year increase in age. Conclusion: Exercise capacity was found decreased in pre-hypertensives and they have high daily salt intake. Also, weight and age emerged as independent risk factors for SBP and DBP respectively. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved. Source

Yadav A.,NIMS Medical College
Journal of Indian Academy of Forensic Medicine

Since last few decades, occupational injuries have been a major cause of morbidity and mortality among people working in factories, especially those working with unprotected rotating machines. Women are specifically prone to such injuries because of their long unprotected hairs being trapped in moving parts of the machines. Long hairs can get entangled in moving machinery resulting in complete or partial avulsion of scalp. A large scalp avulsion injury may lead to severe bleeding and may cause trauma to forehead, eyebrows and per auricular tissue, which may further bring fatal results aesthetically and functionally. Severe deformities as a result of this trauma may lead to severe psychological trauma, disabling the patient to lead a normal social life. Here, we are presenting a case report of a patient who had an occupational injury causing scalp avulsion with cervical spine injury at gang saw machine. Source

Sharma N.,NIMS Medical College | Sharma D.,Jawaharlal Nehru Medical College
Journal of Pharmacology and Pharmacotherapeutics

Fungal infection of the nail as well as nail bed is termed as 'onychomycosis'. It is caused by dermatophytes, non-dermatophytic fungal species and yeasts like Candida albicans. It is traditionally treated by topical antifungals, systemic agents like ketoconazole, griseofulvin, itraconazole, fluconazole, etc. Chemical avulsion or surgical removal of nail can also be tried to treat this disease. In spite of all these treatment options available, podiatrists were always in search of an ideal drug molecule with lesser side effects and which may improve the patient compliance. This exhaustive search led to the discovery of a better antifungal agent, known as 'Tavaborole.' A systematic literature search was carried out using databases such as PubMed, Cochrane Reviews, Google Scholar, etc. Detailed information about onychomycosis and tavaborole was gathered. Tavaborole is the first oxaborole antifungal agent approved by FDA in July 2014. It is marketed under the trade name 'Kerydin.' It acts by inhibiting protein synthesis in the fungus. It inhibits an enzyme known as cytosolic leucyl-transfer RNA synthetase, or LeuRS, which plays a key role in fungal essential protein synthesis. Dermatitis at the site of topical application, erythema, exfoliation and ingrowing toe nail has been reported in 1% of subjects. Tavaborole may offer a promising role in the treatment of onychomycosis and may compell podiatrists to offer its use in onychomycosis. The present study describes about chemical nature, mechanism of action and two completed phase 3 clinical trial findings of Tavaborole. © 2015 Journal of Pharmacology and Pharmacotherapeutics | Published by Wolters Kluwer - Medknow. Source

Gupta A.,Medicity | Dadheech G.,NIMS Medical College | Yadav D.,SMS Medical College | Sharma P.,All India Institute of Medical Sciences | Gautam S.,Gautam Institute of Behavioral science and Alternative Medicine
Indian Journal of Clinical Biochemistry

Schizophrenia is a psychotic disorder with a complex pathophysiology and requires treatment that includes long term administration of antipsychotics that is said to be associated with metabolic syndrome. This study was designed to evaluate the impact of seven different antipsychotics prescribed to schizophrenic patients, on development of metabolic syndrome in the patients. A total of 210 patients with schizophrenia (30 patients in each drug therapy group) were recruited according to ICD-10 criteria and were assigned to receive the drug for 16 weeks. Measurement of anthropometric (body weight, waist circumference, blood pressure) and biochemical parameters (glucose, insulin, HOMA-IR, triglycerides, LDL, HDL) was done and the patients were subjected to ATP-III defined criteria for metabolic syndrome. Patients undergoing treatment with olanzapine were more prone to metabolic syndrome as the drug induces weight gain after 16 weeks of treatment. It also induces dyslipidemia (P < 0.001) and hyperglycemia (P < 0.01). Clozapine was found to be second most potent drug in inducing metabolic syndrome as the weight in clozapine treated patients increased after 16 weeks, along with a significant increase in glycemic (P < 0.001) and lipid parameters (P < 0.01). Aripriazole and amisulphride are comparatively safer drugs as their role in inducing metabolic abnormalities in schizophrenic patients was insignificant, although the impact of long term administration of these drugs needs to be explored. It is clear from the study that antipsychotic treatment induces metabolic syndrome so, it becomes important that the metabolic and cardiovascular risk factors should be surveillance regularly in schizophrenic patients undergoing antipsychotic treatment. © 2014 Association of Clinical Biochemists of India. Source

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