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Tiwari M.,NIMS Medical College | Bhargava R.,NIMS Medical College
Journal of Clinical Orthopaedics and Trauma | Year: 2013

Chronic muscle & tendon injuries are one of the problems which are encountered by human being since last long time. These injuries are generally repetitive strain injuries, commonly found in athletes. There are various treatments which include conservative methods in initial stages to surgery in later stages. On minimal invasive aspect Ultrasound-guided fenestration and tenotomy surgery has been used with good results as an effective treatment of chronic tendinopathies.1,2 There are various injectable agents which were also researched including simple solutions such as hyperosmolar dextrose. 3 (prolotherapy) to complex orthobiologic agents such as bone morphogenic protein,. 4 but none have achieved uniform success. Platelet rich plasma (PRP) injection has emerged as a treatment alternative for many musculoskeletal conditions. We have done this study on sixty patients to evaluate & compare the effects of platelet rich plasma & steroid injection on patients with planter fasciitis. The results at the 1, 3 & 6 months were evaluated, which showed the good results with platelet rich plasma in comparison to steroid injections. © 2013 Delhi Orthopaedic Association.


Yadav A.,NIMS Medical College
Journal of Indian Academy of Forensic Medicine | Year: 2012

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.


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 | Year: 2014

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.


Sharma N.,NIMS Medical College | Sharma D.,Jawaharlal Nehru Medical College
Journal of Pharmacology and Pharmacotherapeutics | Year: 2015

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.


Bhardwaj V.,NIMS Medical College | Rajeshbhai G.P.,NIMS Medical College
Journal of Clinical and Diagnostic Research | Year: 2013

Introduction: Axial length and anterior chamber depth play an important role in refractive status of the eye in different age groups. Material and Methods: The present study has been done on 240 patients (480 eyes) who attended eye OPD of Department of Ophthalmology at NIMS Medical College & Hospital Jaipur, Rajasthan, India. The patients attending eye OPD between July 2011 to December 2012 of different ages groups were without significant history of any ocular disease. The axial length and anterior chamber depth were measured and compared. Conclusion: Hypermetropic eyes have shallow anterior chamber depth and shorter axial length as compared to myopic and emmtropic eyes.


Bhardwaj Veena M.S.,Jhalawar Medical College | Alaka Priyadarshani D.,Nims Medical College | Gaurav B.,Nims Medical College
Journal of Clinical and Diagnostic Research | Year: 2013

Introduction: Pterygium is a fibrous growth seen in bulber conjunctiva.it is a non malignant growth which may cause visual impairment. Material and Methods: Pterygium study was done on rural population in out patient department of NIMS Hospital and medical college, Jaipur, Rajasthan, India. 200 patients with 300 eyes which had Pterygium who attended the Eye OPD during 01/06/2011 to 01/03/2012 were taken for study. A detailed history, Visual Acuity, Refractive Status, Size of Pterygium and duration of work which was done outdoors were recorded. All other physical illness were ruled out. The aim of the study is to find the incidence of Pterygium, male/ female ratio, Comparison of size of Pterygium with duration of working hours in outfield. conclusion: The maximum number of patients of pterygium were seen in age group 20-60yrs and there is no difference in male/female ratio.the size of pterygium depends on their duration of working hours in outfield.


PubMed | NIMS Medical College and Shridev Suman Subharti Medical College
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2016

Neuropathy is one of the most troublesome complication affecting individuals with diabetes. The resultant loss of function in peripheral nerves causes loss of protective sensations and impairs patients ability to perceive incipient or even apparent ulcerations in the feet.This study was undertaken to test the hypothesis of alteration in electrophysiological parameters of nerve before actual manifestations of neuropathy in type 2 diabetic patients and to analyse the effect of smoking on Sensory Nerve Conduction Velocity (SNCV) of diabetic subjects.One hundred and twenty diagnosed diabetics were taken as cases while 30 healthy non diabetics were taken as control. Case group was divided into diabetic non-smoker and diabetic smoker. Diabetic smoker were further subdivided into light smoker, moderate smoker and heavy smoker according to smoking index. After detailed history and physical examination SNCV of median and ulnar nerve in upper limb and sural nerve in lower limb was performed.On comparison of SNCV of median and ulnar nerve of upper limb and sural nerve of lower limb between control and diabetic non-smoker only sural nerve of diabetic non smoker showed significant bilateral decrease. There was significant bilateral decrease in SNCV of median and ulnar nerve of diabetic heavy smoker when compared to control and diabetic non smoker. Similarly, SNCV of sural nerve of diabetic heavy smoker was significantly decreased when compared with control, diabetic non-smoker, diabetic light and moderate smoker. A negative and statistically significant correlation was found between SNCV and smoking index.Present study indicates that nerves of lower limbs are more susceptible to diabetic assault as compared to upper limb suggesting that long nerves are commonly affected. Also, apart from duration and severity of diabetes, smoking itself is an independent factor for diabetic neuropathy.


PubMed | NIMS Medical College
Type: Journal Article | Journal: Journal of orthopaedic case reports | Year: 2016

Reduced intrauterine space gives rise to packaging disorder which may involve joint dislocations or contractures. We present an unique case where mutiple joints were dislocated involving left congenital knee dislocation (CDK), bilateral congenital hip dislocation (CDH) and congenital talipes equino varus (CTEV)deformities.A preterm baby boy born to mother with diagnosed oligohydramios presented with left CDK bilateral DDH and CTEV. The knee dislocation was treated first with gradual streaching and weekly above knee cast. At 7th week good flexion was achieved at both knees and abduction splint for DDH (using double diaper) with ponseti cast for CTEV was done. At one year follow up all joints were reduced and maintained well with baby able to stand with support.Packaging disorders may present with multiple dislocations and deformities. Early intervention with serial casting and manipulation minimises disability and prevents ambulatory problems. In our case there was a good response to manipulation and serial casting. This differs from cases with inherent pathology like arthrogryposis where response to treatment is not so good.


PubMed | NIMS Medical College and Institute of Respiratory Medicine
Type: Journal Article | Journal: The Indian journal of tuberculosis | Year: 2016

CAT IV regimen or the standardized drug regimen (SDR) under the Revised National Control Program (RNTCP) uses six second-line anti-tubercular drugs in the initial intensive phase (IP). These drugs have many side effects and toxicity; they are less efficacious and have poor acceptability. The present study was conducted to evaluate the efficacy and outcome of Cat-IV regimen and the factors which influence the treatment outcome in MDR TB patients.It was a prospective observational study, which was done in the CAT II treatment failure, LPA proven MDR TB patients, above the age of 18 years, who were referred to DOTS Plus center for treatment. The study was approved by the hospital ethics committee and patient consent was obtained before inclusion.We observed culture conversion in 63.04% and ADR in 96.5%, default in 15.65%, and death in11.3% cases. The factors which influenced outcome included low body weight, long duration of illness cavitatory disease and indulgence in both tobacco & alcohol. The radiological favorable response strongly and significantly correlated with the bacteriological and clinical response during the IP.We suggest that the efficacy can be further augmented by reducing default and controlling deaths which accounts for substantial numbers and occur mostly during IP.


PubMed | NIMS Medical College and Jawaharlal Nehru Medical College
Type: Journal Article | Journal: Journal of pharmacology & pharmacotherapeutics | Year: 2016

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.

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