Punjab Institute of Medical science

Jalandhar, India

Punjab Institute of Medical science

Jalandhar, India
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Sharma S.K.,Punjab Institute of Medical science | Vij A.S.,Punjab Institute of Medical science | Sharma M.,New York University
European Journal of Pharmacology | Year: 2013

Capsaicin is the active ingredient of chili peppers and gives them the characteristic pungent flavor. Understanding the actions of capsaicin led to the discovery of its receptor, transient receptor potential vanilloid subfamily member 1 (TRPV1). This receptor is found on key sensory afferents, and so the use of capsaicin to selectively activate pain afferents has been studied in animal and human models for various indications. Capsaicin is unique among naturally occurring irritant compounds because the initial neuronal excitation evoked by it is followed by a long-lasting refractory period, during which the previously excited neurons are no longer responsive to a broad range of stimuli. This process known as defunctionalisation has been exploited for therapeutic use of capsaicin in various painful conditions. We reviewed different studies on mechanisms of action of capsaicin and its utility in different clinical conditions. A beneficial role of capsaicin has been reported in obesity, cardiovascular and gastrointestinal conditions, various cancers, neurogenic bladder, and dermatologic conditions. Various theories have been put forth to explain these effects. Interestingly many of these pharmacological actions are TRPV1 independent. This review is aimed at providing an overview of these mechanisms and to also present literature which contradicts the proposed beneficial effects of capsaicin. Most of the literature comes from animal studies and since many of these mechanisms are poorly understood, more investigation is required in human subjects. © 2013 Elsevier B.V. All rights reserved.

Seth S.,Punjab Institute of Medical science | Kumar H.,Punjab Institute of Medical science
Clinical Rhinology | Year: 2017

Button batteries presenting as foreign bodies in the nasal cavity are rarely seen but common in pediatric age group. They are hazardous due to the extensive nature of damage caused by them. In this study, we discuss the case of a child with impacted button battery in the nasal cavity. A 7-year-old boy presented with bilateral foul-smelling nasal discharge since 6 months. It was purulent, yellowish-green, often blood stained. Radiograph showed evidence of a button battery in the left nostril. The foreign body was removed endoscopically and it was found that there was a perforation in the nasal septum. Early recognition and management is the key to prevention of complications due to foreign bodies, especially corrosive type. © 2017, Jaypee Brothers Medical Publishers (P) Ltd. All rights reserved

Chopra S.,Punjab Institute of Medical science | Arora U.,Chintpurni Medical College Pathankot
Journal of Clinical and Diagnostic Research | Year: 2012

Background and Aims: The HIV infection is associated with several dermatological conditions which may be the first pointer towards the existence of HIV. These may present with unusual and atypical manifestations in the course of the HIV infection. Keeping this in mind, the seroprevalence of HIV in these persons and the spectrum of the skin and the mucocutaneous lesions in the HIV positive patients was studied. Methods: The current prospective study was conducted over a period of 3 years (2006-2008). A total of 604 persons who had any kind of skin and mucocutaneous infections were screened for the HIV infection as per the NACO guidelines after recording their clinical and epidemiological profiles. Results: Out of the 604 patients who were screened, 90(14.90%) were seropositive for the HIV-I antibodies and none was positive for the HIV-2 antibodies. Seventy three point thirty three percent 73.33 of the seropositive patients were in the age group of 15-40 years, with a male-female ratio of 1:1.05. The heterosexual route was the most common mode of transmission (86.6%).A wide range of infectious and noninfectious lesions were observed. In the HIV seropositive patients, oral candidiasis (32.22%) was the most common infectious disease which was observed, followed by herpes zoster (13.33%), genital warts (7.77%) and genital herpes (6.66%). The most common noninfectious manifestation was seborrhoic dermatitis (8.88%), followed by pruritic papular eruptions (7.77%). Conclusion: As there is a high prevalence of the HIV infection in patients who have skin and mucocutaneous disorders, the doctors, during the investigation of these patients, must have a high level of suspicion for the HIV infection in their mind. An early detection of HIV optimizes the chemoprophylaxis for many opportunistic mucocutaneous disorders.

Mittal P.,Punjab Institute of Medical science | Mittal G.,Punjab Institute of Medical science
Journal of Neurosciences in Rural Practice | Year: 2011

Combined clinical presentation of hemifacial spasm and ipsilateral trigeminal neuralgia is also known as painful tic convulsif (PTC). It is a rare condition and the most common cause is vascular compression. Vertebrobasilar dolichoectasia (VBD) is characterized by dilated and tortuous vertebral and basilar arteries. VBD is an uncommon and rarely reported cause of PTC. Magnetic resonance imaging (MRI), due to its inherent excellent contrast resolution, is an excellent modality for demonstrating the nerve compression by dilated and tortuous vessels seen in this condition. For this purpose, 3D MRI sequences are especially useful like constructive interference in steady state (CISS) and MR angiography. Both of these have been reported to be helpful in the diagnosis of this condition. We report a case of PTC in which we were able to document facial and trigeminal nerve compression by VBD on MRI, using CISS and time-of-flight MR angiography.

Ghosh Y.,Punjab Institute of Medical science | Arora R.,Punjab Institute of Medical science
Journal of Clinical and Diagnostic Research | Year: 2014

Torsion of greater omentum is one of the rare causes of acute abdominal pain. It can be primary or secondary. Primary Omental Torsion (POT) occurs because a mobile, thicken segment of omentum rotates around a proximal fixed point in the absence of any associated or secondary intra-abdominal pathology. Secondary omental torsion is associated with a number of pre-existing conditions most common among them is inguinal hernia, other causes include tumours, cysts, internal or external herniation, foci of intra-abdominal inflammation and postsurgical wound or scarring. Torsion of omentum causes twisting of omentum along its long axis resulting in impaired blood supply. This rare condition is more predominant in middle-aged males. It clinically mimics acute appendicitis. It should be kept in mind as a differential diagnosis for acute abdomen. Laparoscopy can aid in diagnosis and management but explorative laparotomy is the definitive and therapeutic procedure of choice. However the condition is not life threatening as omentectomy reduces the inflammation and focus of adhesions within the abdomen.

Bhatia H.K.,Jawaharlal Institute of Postgraduate Medical Education & Research | Singh H.,All India Institute of Medical Sciences | Grewal N.,Punjab Institute of Medical science | Natt N.K.,District TB Hospital
Journal of Pharmacology and Pharmacotherapeutics | Year: 2014

Hepatitis C currently infects more than 170 million people around the world, leading to significant morbidity and mortality. The current standard of care for HCV infection, including one of the two protease inhibitors, telaprevir or boceprevir, for 12-32 weeks, along with pegylated interferon alfa-2a (PEG-IFN-γ) and ribavirin for up to 48 weeks, is unsatisfactory in many cases, either because of lack of efficacy or because of treatment-related adverse effects. There is an urgent need of new drugs with improved efficacy as well as a safety profile. Sofosbuvir, a recently approved nucleotide analog, is a highly potent inhibitor of the NS5B polymerase in the Hepatitis C virus (HCV), and has shown high efficacy in combination with several other drugs, with and without PEG-INF, against HCV. It offers many advantages due to its high potency, low side effects, oral administration, and high barrier to resistance. The efficacy and safety were demonstrated in many large and well-designed phase 2 and phase 3 clinical trials like NEUTRINO, PROTON, ELECTRON, ATOMIC, COSMOS, FUSION, FISSION, NUCLEAR, POSITRON, and the like. It is generally well-tolerated. Adverse events that occurred include: Headache, insomnia, fatigue, nausea, dizziness, pruritis, upper respiratory tract infections, rash, back pain, grade 1 anemia, and grade 4 lymphopenia; however, the exact safety profile can only be judged when this drug is actually used on a large scale.

Mittal P.,Punjab Institute of Medical science
Annals of Indian Academy of Neurology | Year: 2011

Medulloblasoma is a common posterior fossa tumor seen in children and presents with some typical features like midline vermian location and fairly homogeneous enhancment. Desmoplastic variety of medulloblastoma is usually seen in the adults and is known to show some atypical features like lateral cerebellar location, variable enhancement, and early meningeal infilteration. Therefore medulloblastoma should always be considered in differential diagnosis of posterior fossa mass in adults even when typical imaging findings are not that of medulloblastoma. Enhancement pattern can be variable in these tumors varying from mild to striking. Occasionally, totally non-enhancing tumors are encountered, which can cause further diagnostic confusion. We describe the magnetic resonance (MR) and MR spectroscopy findings in a case of midline vermian mass, which did not show any enhancement on post-contrast images, and was subsequently proven to be desmoplastic medulloblastoma. On MR spectroscopy, the mass showed elevated choline peak consistent with mitotic lesion. No significant lipid lactate leak was seen, which is also consistent with the ususally homogeneous nature of these tumors. Moreover, it displayed taurine peak at 3.4 ppm which is considered fairly specific for medulloblastoma. Therefore, MR spectroscopy findings can be helpful in the diagnosis of medulloblastoma in adults when MR imaging findings can be nonspecific.

Kaur J.,Punjab Institute of Medical science
Journal of Clinical and Diagnostic Research | Year: 2013

Background and Objectives: Various phenotypic methods are recommended in the routine practice to detect the ESBL production in gram negative bacilli. Among them, the Double Disc Synergy Test (DDST) which uses the third generation cephalosporins (3GC), is a simple and a reliable method. But the coexistence of AmpC may give false negative results. In such cases, the ESBL detection can be improved by using cefepime along with the third generation cephalosporins in DDST. Methods: A total of 350 urinary isolates (224 Escherichia coli and 126 Klebsiella pneumoniae) were studied for ESBL production by the modified double disc test (MDDST) i. e. by using cefotaxime, ceftriaxone, cefpopdoxime (third generation cephalosporins) and cefepime (fourth generation cephalosporin) along with a amoxicillin-clavulanate disc. Results and Interpretation: ESBL production was seen in 63. 4% (142/224) Escherichia coli and in 60. 3% (76/126) Klebsiella pneumoniae isolates by MDDST. Among these, in twelve E. coli and five K. pneumoniae strains, only cefepime but none of the third generation cephalosporins showed synergism with amoxicillin-clavulanate. All these seventeen strains showed a clear extension of the edge of inhibition which was produced by cefepime towards the amoxicillin-clavulanate disc. These strains were further tested for AmpC co-production by the AmpC disc test and all these strains were found to be AmpC positive, thus revealing the superior activity of cefepime in detecting ESBLs in the bacteria which co-produced AmpC. A high degree of co-resistance was found in the ESBL producers. Conclusion: The ESBL detection can be improved by MDDST by using cefepime along with the third generation cephalosporins.

Dua A.,Punjab Institute of Medical science
The journal of knee surgery | Year: 2010

Coronal plane fractures of the femoral condyle are infrequent injuries and are often missed. Unilateral bicondylar coronal plane fractures are even rarer, with only eight reported cases in scientific literature, and are often associated with other injuries. We present here a case of unilateral bicondylar Hoffa fracture that presented in our emergency department and was managed with open reduction and internal fixation by lateral parapatellar arthrotomy using the swashbuckler approach with satisfactory results.

Mittal P.,Punjab Institute of Medical science
Iranian Journal of Radiology | Year: 2011

Hemichorea-hemiballism (HCHB) syndrome, which is most commonly related to non-ketotic hyperglycemia, is a rare type of chorea. Here, we present an unusual case of HCHB syndrome who was not a known case of diabetes. This case highlights the importance of recognising underlying non-ketotic hyperglycemia, as control of hyperglycemia is helpful in the quick relief of symptoms.

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