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Patel T.A.,Pramukh Swami Medical College
Indian journal of public health | Year: 2011

A cross-sectional study was conducted in a rural area of Anand District, Gujarat to measure the efficiency of immunization sessions and to identify the reasons for missing a vaccine in a session. Caregivers of infants aged less than one year and in need of any vaccine as per routine immunization schedule were interviewed by a house-to-house survey after immunization session was completed. Efficiency of immunization session was 66.7%. Reasons for 'missed' vaccination were prior reminder not given (32.9%, P<0.01); mother's forgetfulness (26.6%); unavailability of vaccine (15%). Higher birth order (OR=2.86; 3.16-2.56), mother's current residence at father's home (OR=3.17; 3.53-2.81) were associated with 'missed' vaccination. There are barriers in health care system such as lack of prior reminder and unavailability of vaccines which should be assessed and eliminated. Source

Dhanani J.V.,Gujarat Adani Institute of Medical science | Chauhan L.N.,Pramukh Swami Medical College
Journal of Pharmacology and Pharmacotherapeutics | Year: 2012

Objective: To compare the efficacy and safety with a fixed dose of two parenteral iron preparations, iron sucrose complex and iron sorbitol citric acid as per the current practice. Materials and Methods: A prospective randomized open label study was conducted. In this study, 60 pregnant women with hemoglobin less than 8.5 g/dl received a fixed dose of either IV iron sucrose or IM iron sorbitol citric acid therapy. The efficacy of the therapy was assessed by laboratory parameters such as hemoglobin, hematocrit, MCV, MCH, and serum ferritin level after 14 and 28 days. To assess the safety, adverse drug reactions with both the therapies were recorded. Results: Hemoglobin concentration increased significantly (P < 0.001) with respect to time in both the groups. The rise in the hemoglobin level in third and fourth weeks was significantly higher in iron sucrose (0.92 g/dl) than iron sorbitol citric acid therapy (0.56 g/dl). There was no significant change in the rise of the serum ferritin level after both the therapies. Adverse events were common with iron sorbitol citric acid therapy. However, no serious adverse drug reactions were observed. Conclusions: No significant difference in the efficacy of both of the therapy. However, adverse events and dropout rates were much more common in the group of pregnant women who received iron sorbitol citric acid. Source

Mohan S.,Sardar Patel University | Kalia K.,Sardar Patel University | Mannari J.,Pramukh Swami Medical College
Indian Journal of Clinical Biochemistry | Year: 2012

Abnormal glomerular permeability is the primary step towards the glomerulosclerosis. The progression rate of glomerulosclerosis is proportionate to abundance and severity of lesions created at incipient stage, which is reflected as proteinuria even though eGFR remains in the normal range. Therefore, there is a current need to find out the association between relative risks for the factors leading to proteinuria. The relations could be more informative, if it is with respect to the macromolecules like IgG excretion in urine. Type 2 diabetic patients were selected for this study with eGFR > 75 ml/min/1.73 m 2 and grouped into four quartiles based on UIgGCR. The markers of key factors affecting progression of proteinuria were estimated through biochemical tests. The impact of these markers on proteinuria was accessed by applying multinomial logistic regression. The adjusted odds ratio for the UGAGCR was 1.186 (95 % CI: 1.061-1.327) P < 0.003 in highest quartiles of UIgGCR, followed by odds ratio for markers of collagen catabolism 1.051 (95 % CI: 1.025-1.079) P < 0.001, and USACR 1.044 (95 % CI: 1.013-1.077) P < 0.006 respectively. The marker of glycation, i.e., glycated hemoglobin showed the highest odds ratio 5.449 (95 % CI: 1.132-26.236) P < 0.035. In addition, odds for the systolic blood pressure was observed 1.387 (95 % CI: 1.124-1.712) P < 0.002. The higher odds inform and could help to discriminate the diabetic patients with fast progressive diabetic nephropathy. The study describes critical relationship between the urinary excretion of IgG and factors leading to proteinuria in type 2 diabetic patients. © 2012 Association of Clinical Biochemists of India. Source

Mohan S.,Sardar Patel University | Kalia K.,Sardar Patel University | Mannari J.,Pramukh Swami Medical College
International Journal of Diabetes in Developing Countries | Year: 2012

Predominantly diabetic nephropathy starts with glomerulosclerosis, when plasma molecules cross the dismantled glomerular basement membrane (GBM) and subsequently appear in urine. Therefore proteinuria is a sensitive criterion to diagnose progressive renal impairment and the presence of immunoglobulin like large molecules is potentially able to predict severity of nephropathy. Directly, or indirectly hyperglycemia induces proteinuria and high urinary excretion of IgG appears with progression of glomerular injury. This is an observational study of 683 patients with type 2 diabetes mellitus. Patients with varying degree of proteinuria were enrolled and classified into three groups according to the urinary albumin creatinine ratio (UACR, <29, 30-299, >300 mg/g creatinine.) and each group was further sub-classified into the low and high urinary IgG creatinine ratio (UIgGCR) based on the median value. Biochemical parameters were analyzed by standard laboratory methods. The association of proteinuria and odds ratio for risk factors of diabetic nephropathy was estimated using multinomial logistic regression models. The normoalbuminuric and microalbuminuric patients with high UIgGCR had shown lower eGFR (p<0.05). There was no interaction observed between higher UIgGCR and lower eGFR in regression model analysis. Multinomial logistic regression model estimated the odds ratio for the AGEs, AOPP, lipid hydroperoxides and lipid peroxidation products were increased; 5.64 (95% CI 3.52-9.04), 1.03 (95% CI 1.02-1.04), 2.71 (95% CI 2.05-3.57) and 13.72 (95% CI 6.98-26.95) respectively with high UIgGCR in diabetic patients. High UIgGCR has shown a significant association with decreased eGFR and increased odds for potential hazardous factors. The current study has shown UIgGCR as an increased relative risk, and threat for rapid progression of diabetic nephropathy, possibly because GBM is the primary vulnerable site for deterioration by several hazardous metabolites. In conclusion, association between fractional clearance of IgG and relative risk of GBM threatening factors should be useful for prediction of progressive nature of diabetic nephropathy. © 2012 Research Society for Study of Diabetes in India. Source

Vadiya S.I.,Pramukh Swami Medical College
Indian Journal of Otology | Year: 2014

Aim: Use of cartilage for repair of tympanic membrane is recommended by many otologists. The current study aims at evaluating results of cartilage shield tympanoplasty in terms of graft take up and hearing outcomes. Material and Methods: In the current study, cartilage shield tympanoplasty(CST) is used in ears with high risk perforations of the tympanic membrane. A total of 40 ears were selected where type I CST was done in 30 ears and type III CST was done in 10 ears. Results: An average of 37.08 dB air bone gap(ABG) was present in pre operative time and an average of 19.15 dB of ABG was observed at 6 months after the surgery with hearing gain of 17.28 dB on average was observed. Graft take up rate of 97.5% was observed. The technique is modified to make it easier and to minimize chances of lateralization of graft. Conclusion: The hearing results of this technique are comparable to other methods of tympanic membrane repair. © 2014 Indian Journal of Otology. Source

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