Rājkot, India
Rājkot, India

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Mehta K.D.,MPSMC | Vacchani A.,PDU Medical College | Mistry M.M.,PDU Medical College | Kavathia G.U.,PDU Medical College | Goswami Y.S.,PDU Medical College
Journal of Clinical and Diagnostic Research | Year: 2013

Background and objectives: Enteric parasites are a major cause of diarrhoea in HIV infected individuals. The present study was undertaken to detect the enteric parasites in HIV infected patients with diarrhoea, who were at different levels of immunity. Methods: This study was carried out in the P.D.U Medical College and Civil Hospital, Rajkot, India. during the period from June 2009 to June 2010. A total of 100 stool samples from HIV seropositive patients were examined for opportunistic, gastrointestinal parasitic infections. The samples were classified according to the age groups, sex, and occupation, a history of diarrhoea and different categories of the CD4 cell count. The stool samples were collected and examined for enteric parasites by microscopy and by special staining methods. The CD4 cell counts were estimated by using the FACS count system. Results: The intestinal parasitic pathogens were detected in 28% patients. Among all, Isospora appeared to have the highest prevalence (18%), followed by Giardia lamblia (5%), Strongyloides stercoralies (3%) and Cryptosporidium parvum (2%). In the HIV infected patients with a CD4 count of < 200 cells/μl, Isospora was the most commonly observed (56%) pathogen. The proportion of the opportunistic pathogens in the patients with CD4 counts of <200 cells/μl was significantly higher as compared to those in the other two groups of patients with CD4 counts of >200 respectively. Interpretation and conclusions: Parasitic infections were detected in 28% of the HIV infected patients and a low CD4 count was significantly associated with an opportunistic infection. The detection of the aetiologic pathogens might help the clinicians in deciding the appropriate management strategies.


PubMed | PDU Medical College, St George's, University of London, University of Delhi, Erasmus Medical Center and 5 more.
Type: Journal Article | Journal: PloS one | Year: 2016

Spirometry datasets from South-Asian children were collated from four centres in India and five within the UK. Records with transcription errors, missing values for height or spirometry, and implausible values were excluded(n = 110).Following exclusions, cross-sectional data were available from 8,124 children (56.3% male; 5-17 years). When compared with GLI-predicted values from White Europeans, forced expired volume in 1s (FEV1) and forced vital capacity (FVC) in South-Asian children were on average 15% lower, ranging from 4-19% between centres. By contrast, proportional reductions in FEV1 and FVC within all but two datasets meant that the FEV1/FVC ratio remained independent of ethnicity. The GLI-Other equation fitted data from North India reasonably well while GLI-Black equations provided a better approximation for South-Asian data than the GLI-White equation. However, marked discrepancies in the mean lung function z-scores between centres especially when examined according to socio-economic conditions precluded derivation of a single South-Asian GLI-adjustment.Until improved and more robust prediction equations can be derived, we recommend the use of GLI-Black equations for interpreting most South-Asian data, although GLI-Other may be more appropriate for North Indian data. Prospective data collection using standardised protocols to explore potential sources of variation due to socio-economic circumstances, secular changes in growth/predictors of lung function and ethnicities within the South-Asian classification are urgently required.


Joshi U.,Smt NHL Municipal Medical College | Modi B.,PDU Medical College | Yadav S.,Shri MP Shah Medical College
Indian Journal of Community Medicine | Year: 2010

Background: Awareness towards tobacco hazards has increased with time but its role alone towards cessation is questionable. With widespread menace of tobacco in developing countries like India, not much tobacco chewing prevalence and their quitting patterns data are available in urban Saurashtra region. Objectives: 1. To find out prevalence of various forms of chewing tobacco and quitting attitudes in urban Jamnagar. 2. To study quitting patterns in relation with age of habit initiation, family background and habit duration. Materials and Methods: It was a cross-sectional study involving 2513 individuals as study population by 30-cluster sampling method. The study was carried out between June 2007 and March 2008. Pre-set, pre-tested questionnaire was used for interview purpose and the statistical analysis was done on proportion basis. Results: About 37.2% of study population was ever-tobacco-chewers; 32.9% of them were current-chewers and 4.3% were quitters. Approximately 28.4% of current-consumers were willing to quit. Mawa-masala (63.7%) and Gutka (57.6%) were preferred forms of chewing tobacco and 57.5% of the current-chewers chewed tobacco six to eight times a day. Tobacco initiation age between 20 and 30 years was commoner among quitters (84.2%), while a little younger in current-consumers (76.5%). About 58.3% quitters and 74.0% chewers showing willingness to quit had not consumed tobacco for more than five years, 63.8% of current-chewers had a family member consuming tobacco. With initiation of health problems, 72.2% subjects quit and 55.5% of them already knew about health hazards. Conclusions: Every 4 out of 10 residents was found to be exposed to chewing tobacco. With Mawa-masala and Gutka being the predominant forms, habit onset in late adolescence, years of consumption and family exposure seem to be hampering quitting. Awareness about tobacco hazards alone does not appear to be resulting in successful quitting.


Joshi U.,Smt Nhl Municipal Medical College | Kadri A.,PDU Medical College | Bhojiya S.,Gujarat State AIDS Control Society
Indian Journal of Sexually Transmitted Diseases | Year: 2010

Background and Objectives: Risk of vertical transmission (largest source of HIV in children) reduces from 33% to 3% with effective prevention of mother to child transmission (PMTCT) interventions. NACP-III has got an objective of testing all pregnant women for earliest linkage with PMTCT. Study was carried out to find out PPTCT service coverage, dropouts, intervention efficacy with other determinants. Materials and Methods: At ICTCs, registered ANCs are counseled and tested for HIV. HIV +ve ANCs are additionally linked to services and followed-up for institutional delivery, sdNVP, nutrition and children testing. HIV +ve ANCs since 2005 subsequently delivered till June 2008 and their exposed children in Gujarat's category A, B districts constituted study cohort. Results: 259622 pregnant women registered, 72.1% were counseled pre-test, 83.4% of them tested, 74.4% received post-test counseling. 541 ANCs were detected HIV+ve. 45.5% delivered institutionally, 12.8% were unregistered. 12.1% were cesarian section and 66% delivered vaginally. 96.8% were live births, 92.13% mother-baby pair received sdNVP. 35% children could be traced till 18 months, 89% were alive. 90% were tested, 3 were found HIV +ve. Of them, none received MB Pair. Two were delivered vaginally, two received mixed feeding, two children's mothers were not linked with ART. Conclusions: PMTCT services - counseling and testing should be provided to all ANCs. EDD-based tracking, institutional deliveries, postnatal counseling to be encouraged along with complete MB pair coverage, capacity building of concerned staff regarding delivery of HIV+ve ANCs and exposed children tracking.


Javdekar R.,PDU Medical College | Maitra N.,Medical College and SSG Hospital
Journal of Obstetrics and Gynecology of India | Year: 2015

Background: The discrimination between benign and malignant adnexal masses is central to decisions regarding clinical management and surgical planning in such patients. Purpose of Study: To determine if the RMI (RMI 2) can distinguish between benign and malignant adnexal masses. Methods: A prospective cohort study was conducted of 58 women with an adnexal mass referred to a teaching hospital for diagnosis and management. Results: RMI > 200 had a sensitivity of 70.5 % (95 % CI 46.87–86.72), a specificity of 87.8 % (95 % CI 74.46–94.68), a positive predictive value of 70.5%, and negative predictive value of 87.8 %. ROC showed that cut off value of 25 achieved a sensitivity and specificity of 82.35 and 43.9 %, respectively, and a cut off value of 1,000 gave a sensitivity and specificity of 58.81 and 97.56 %, respectively. The association between RMI and disease status was not statistically significant for mucinous tumors. Conclusion: RMI is a reliable tool in differentiating benign from malignant adnexal masses. It is simple, easy to use and cost effective. However it’s predictive accuracy was less for mucinous as compared to serous epithelial ovarian cancers. The study is limited by its small sample size. © 2014, Federation of Obstetric & Gynecological Societies of India.


Kumar S.,Government Medical College | Pathak A.,FMT | Mangal H.M.,PDU Medical College
Journal of Indian Academy of Forensic Medicine | Year: 2011

Everyday around the world almost 700 people die from the poisoning and several thousands more are affected by poisoning. Poisoning occurs in all regions and countries and affects people in all age and income group. Major occupation in Saurashtra region of Gujarat is farming with majority of population living in rural areas where the cases of accidental and suicidal poisoning are common and incidences are increasing day by day due to the use of pesticides for a wider variety of purposes. A detailed knowledge about the nature and magnitude of the poisoning cases in this particular area is not only important for early diagnosis and prompt treatment but also it may help to form policies to curb the access of the population to certain very toxic substances. The present study was undertaken in the department of Forensic Medicine at Rajkot (Gujarat) to know the pattern of fatal poisoning. Total 208 cases of death due to fatal poisoning were selected for this prospective study, which were brought to us for postmortem examination during the span of one year (From January 2007 to December 2007). Our study revealed that most of the victims of fatal poisoning were Hindus, married males of middle socio-economic status who died due to self ingestion of some poison.


Chudasama R.,PDU Medical College | Patel U.V.,PDU Medical College | Ravikant R.,PDU Medical College | Verma P.H.,PDU Medical College
Indian Pediatrics | Year: 2011

Objective: To compare prevalence of goitre in primary school children;to determine median urinary iodine concentration in children;and, to assess level of salt iodization at retail trader level. Design: 30 cluster survey study. Settings: Primary schools of Kutch district, Gujarat, India. Methods: Total 70 students including five boys and five girls from 1st to 7th standard, present in class on the day of visit were selected randomly for Goitre examination (n=2100). Urine sample was collected from one boy and one girl from each standard in each cluster. From the community, 28 children, including two boys and two girls from each standard in the same age group were examined, and salt samples were tested from their households. From each village, one retail shop was visited and various salts available were purchased and tested for iodine on the spot with spot kit. Results: Goitre prevalence of 11.2% was found among primary school children (grade 1- 8.6% and grade 2-2.6%). As the age increased, the Goitre prevalence also increased except in age group of 8 years. Median urinary iodine excretion level was 110 μg/L. Iodine level more than 15 ppm was found in 92.3% salts samples tested at the household level. Conclusion: Present study showed mild goiter prevalence in primary school children in Kutch district of Gujarat.


Dhruva Gauravi A.,PDU Medical College | Agravat Amit H.,PDU Medical College | Pujara Krupal M.,PDU Medical College
Online Journal of Health and Allied Sciences | Year: 2012

Background: Transfusion of blood and blood products is a life saving intervention and benefits innumerous patients worldwide. At the same time it could be an ominous mode of infection transmission to recipients. In 15 percent of total patients infected with HIV, blood transfusion has been the responsible mechanism of transmission. Methods: In this study, we aimed to access the prevalence and trend of HIV, HBV, HCV and Syphilis over the last 31/2 years (January 2008 to June 2011) among the blood donors who came to donate blood at Blood Bank, P.D.U. Medical College & Hospital, Rajkot as well as in various blood donation camps organized by the same blood bank. Results: From the total of 30,178 blood donors, 711 (2.35%) had serological evidence of infection with at least one pathogen, either of HIV, HBV, HCV or Syphilis. These included 131 (0.43%) with HIV, 293 (0.97%) with HBV, 124 (0.41%) with HCV and 94 (0.31%) with Syphilis. Moreover, significantly declining trends of HIV, HBV and Syphilis was observed over the study period. Conclusion: A substantial percentage of blood donors harbor HIV, HBV, HCV and Syphilis infections. Strict selection of blood donors and comprehensive screening of donors' blood using standard methods are highly recommended to ensure the safety of blood for recipient.


PubMed | PDU Medical College and Government Medical College
Type: Journal Article | Journal: Journal of family medicine and primary care | Year: 2016

Type 2 diabetes mellitus (T2DM) is a proven threat of cardiac dysautonomia with paucity of studies from India. Poor disease control makes it further worse with co-existence of hypertension in majority. Heart rate variability (HRV) is a validated noninvasive tool to assess cardiac autonomic status.We studied HRV parameters of type 2 diabetics looking for effects of disease control and other co-existing risk factors.Ninety-eight hypertensive and forty normotensive under-treatment, Gujarati type 2 diabetics were evaluated for disease control and risk stratification. Five minutes resting, HRV was measured by Variowin HR, software-based instrument, using standard protocols to record time domain, frequency domain, and Poincare plot HRV parameters. They were compared between subgroups for the difference with All HRV parameters were reduced in type 2 diabetics, having mean age 56 years, mean duration 6 years with poor glycemic but comparatively better pressure control. HRV parameters were significantly not different in good compared to poor glycemics or in subjects with optimum pressure control than those without it. Results did not differ significantly, by the presence of individual cardiovascular risk factor in diabetics except resting heart rate.Our findings of HRV suggest that type 2 diabetics with poor glycemic control do not have a significant difference of cardiac dysautonomia by pressure control, glycemic control, and absence of risk cardiovascular factor. It suggests diabetes as a major cause for cardiac dysautonomia, residual risk despite treatment and need for HRV screening, strict glycemic control, and further studies.


PubMed | PDU Medical College and Medical College and SSG Hospital
Type: Journal Article | Journal: Journal of obstetrics and gynaecology of India | Year: 2015

The discrimination between benign and malignant adnexal masses is central to decisions regarding clinical management and surgical planning in such patients.To determine if the RMI (RMI 2) can distinguish between benign and malignant adnexal masses.A prospective cohort study was conducted of 58 women with an adnexal mass referred to a teaching hospital for diagnosis and management.RMI>200 had a sensitivity of 70.5% (95% CI 46.87-86.72), a specificity of 87.8% (95% CI 74.46-94.68), a positive predictive value of 70.5%, and negative predictive value of 87.8%. ROC showed that cut off value of 25 achieved a sensitivity and specificity of 82.35 and 43.9%, respectively, and a cut off value of 1,000 gave a sensitivity and specificity of 58.81 and 97.56%, respectively. The association between RMI and disease status was not statistically significant for mucinous tumors.RMI is a reliable tool in differentiating benign from malignant adnexal masses. It is simple, easy to use and cost effective. However its predictive accuracy was less for mucinous as compared to serous epithelial ovarian cancers. The study is limited by its small sample size.

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