Gupta R.,Fortis Escorts Hospital |
Deedwania P.C.,University of California at San Francisco |
Achari V.,Patna Medical College |
Bhansali A.,Jawaharlal Institute of Postgraduate Medical Education & Research |
And 10 more authors.
American Journal of Hypertension | Year: 2013
OBJECTIVEWe conducted a multisite study to determine the prevalence and determinants of normotension, prehypertension, and hypertension, and awareness, treatment, and control of hypertension among urban middle-class subjects in India. Methods We evaluated 6,106 middle-class urban subjects (men 3,371; women, 2,735; response rate, 62%) in 11 cities for sociodemographic and biological factors. The subjects were classified as having normotension (BP < 120/80), prehypertension (BP 120-139/80-89), and hypertension (documented or BP ≥ 140/90). The prevalence of other cardiovascular risk factors was determined and associations evaluated through logistic regression analysis. Results The age-adjusted prevalences in men and women of normotension were 26.7% and 39.1%, of prehypertension 40.2% and 30.1%, and of hypertension 32.5% and 30.4%, respectively. The prevalence of normotension declined with age whereas that of hypertension increased (P-trend < 0.01). A significant association of normotension was found with younger age, low dietary fat intake, lower use of tobacco, and low obesity (P < 0.05). The prevalence of hypercholesterolemia, diabetes, and metabolic syndrome was higher in the groups with prehypertension and hypertension than in the group with normotension (age-adjusted odds ratios (ORs) 2.0-5.0, P < 0.001). The prevalences in men and women, respectively, of two or more risk factors were 11.1% and 6.4% in the group with normotension, 25.1% and 23.3% in the group with prehypertension, and 38.3% and 39.1% in the group with hypertension (P < 0.01). Awareness of hypertension in the study population was in 55.3%; 36.5% of the hypertensive group were receiving treatment for hypertension, and 28.2% of this group had a controlled BP (< 140/90mm Hg). Conclusion s The study found a low prevalence of normotension and high prevalence of hypertension in middle-class urban Asian Indians. Significant associations of hypertension were found with age, dietary fat, consumption of fruits and vegetables, smoking, and obesity. Normotensive individuals had a lower prevalence of cardiometabolic risk factors than did members of the prehypertensive or hypertensive groups. Half of the hypertensive group were aware of having hypertension, a third were receiving treatment for it, and quarter had a controlled BP. © 2012 American Journal of Hypertension, Ltd. All rights reserved.
Llanos-Cuentas A.,Cayetano Heredia Peruvian University |
Lacerda M.V.,Fundacao de Medicina Tropical Doutor Heitor Vieira Dourado |
Rueangweerayut R.,Mae Sot Hospital |
Krudsood S.,Mahidol University |
And 11 more authors.
The Lancet | Year: 2014
Background Clinical eff ectiveness of previous regimens to treat Plasmodium vivax infection have been hampered by compliance. We aimed to assess the dose-response, safety, and tolerability of single-dose tafenoquine plus 3-day chloroquine for P vivax malaria radical cure. Methods In this double-blind, randomised, dose-ranging phase 2b study, men and women (aged ≥16 years) with microscopically confi rmed P vivax monoinfection (parasite density >100 to <100 000 per μL blood) were enrolled from community health centres and hospitals across seven sites in Brazil, Peru, India, and Thailand. Patients with glucose- 6-phosphate dehydrogenase enzyme activity of less than 70% were excluded. Eligible patients received chloroquine (days 1-3) and were randomly assigned (1:1:1:1:1:1) by a computer-generated randomisation schedule to receive singledose tafenoquine 50 mg, 100 mg, 300 mg, or 600 mg, primaquine 15 mg for 14 days, or chloroquine alone. Randomisation was stratifi ed by baseline parasite count (≤7500 and >7500 per μL blood). The primary effi cacy endpoint was relapse-free effi cacy at 6 months from initial dose (ie, clearance of initial infection without subsequent microscopically confi rmed infection), analysed by intention to treat. This study is registered with ClinicalTrials.gov, number NCT01376167. Findings Between Sept 19, 2011, and March 25, 2013, 329 patients were randomly assigned to a treatment group (chloroquine plus tafenoquine 50 mg [n=55], 100 mg [n=57], 300 mg [n=57], 600 mg [n=56]; or to chloroquine plus primaquine [n=50]; or chloroquine alone [n=54]). Relapse-free effi cacy at 6 months was 57.7% (95% CI 43-70) with tafenoquine 50 mg, 54.1% (40-66) with tafenoquine 100 mg, 89.2% (77-95) with tafenoquine 300 mg, 91.9% (80-97) with tafenoquine 600 mg, 77.3% (63-87) with primaquine, and 37.5% (23-52) with chloroquine alone. Tafenoquine 300 mg and 600 mg had better effi cacy than chloroquine alone (treatment diff erences 51.7% [95% CI 35-69], p&0.0001, with tafenoquine 300 mg and 54.5% [38-71], p <0.0001, with tafenoquine 600 mg), as did primaquine (treatment diff erence 39.9% [21-59], p=0.0004). Adverse events were similar between treatments. 29 serious adverse events occurred in 26 (8%) of 329 patients; QT prolongation was the most common serious adverse event (11 [3%] of 329), occurring in fi ve (2%) of 225 patients receiving tafenoquine, four (8%) of 50 patients receiving primaquine, and two (4%) of 54 patients receiving chloroquine alone, with no evidence of an additional eff ect on QT of chloroquine plus tafenoquine coadministration. Interpretation Single-dose tafenoquine 300 mg coadministered with chloroquine for P vivax malaria relapse prevention was more effi cacious than chloroquine alone, with a similar safety profi le. As a result, it has been selected for further clinical assessment in phase 3. Funding GlaxoSmithKline, Medicines for Malaria Venture.
Bhaya M.,Fortis Escorts Hospital |
Beniwal R.,SSR Medical College |
Panwar S.,Sunny Downstate University |
Panwar R.B.,Sardar Patel Medical College
Echocardiography | Year: 2011
Objectives: Out of 1,059 school children aged 6-15 years, screened 2 years ago, 54 children were diagnosed with rheumatic heart disease (RHD) and put on penicillin prophylaxis. Significant regurgitation of mitral valves was detected in 39 cases of echocardiography diagnosed RHD, and in 15 cases significant regurgitation was detected to coexist with valve deformities. Three children had isolated mitral valve thickening without regurgitation. They were not given penicillin prophylaxis. These cases were followed up for 2 years. Methods: After 2 years, 54 children diagnosed with RHD and three children with isolated mitral valve thickening, were evaluated again. Lot quality assurance sampling was employed to screen a selected group of school children declared normal during the earlier evaluation. Lot was to be rejected, if, one child with significant regurgitation of mitral valve was found among the first 10 screened children of each of the 10 lots. Findings: No lot was rejected and thus it was inferred that the prevalence of new onset RHD was negligible in the subset declared normal 2 years ago. Isolated significant mitral regurgitation disappeared more often when present (35.9%) in comparison to when it (26.7%) was originally found coexistent with valve deformities. Conclusions: Highlight of the study is the greater reversibility of earlier lesions as compared to the later stages of RHD. Spontaneous regression of isolated mitral valve thickening in two-thirds of the cases even without antibiotic prophylaxis, undermines the value of morphological criteria for the diagnosis of RHD. © 2011, Wiley Periodicals, Inc.
Khandelwal K.,Sardar Patel Medical College |
Bumb R.A.,Sardar Patel Medical College |
Mehta R.D.,Sardar Patel Medical College |
Kaushal H.,Institute of Pathology |
And 3 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2011
Opportunistic parasitic infections such as leishmaniasis are common in human immunodeficiency virus (HIV)-infected patients and are usually acquired several days after initial diagnosis of HIV infection. Here, we report on a patient who presented with diffuse cutaneous leishmaniasis (DCL) caused by Leishmania tropica as the first and only clinical manifestation of HIV infection. To the best of our knowledge, this is the first case that illustrates that DCL could be the first clinical indicator of HIV infection. Cutaneous leishmaniasis (CL) and DCL are becoming frequent opportunistic infections in HIV-infected individuals throughout the world. To date, all documented cases of CL and HIV coinfections have been reported in patients who were known cases of HIV and who subsequently developed CL. In this report, we present a case that illustrates that DCL could be the first clinical indicator of HIV infection. Copyright © 2011 by The American Society of Tropical Medicine and Hygiene.
Choudhary S.,Sardar Patel Medical College |
Rajnee,Sardar Patel Medical College |
Binawara B.K.,Sardar Patel Medical College
Journal of Postgraduate Medical Institute | Year: 2012
Objective: The aim of present study was to assess the impact of exercise in trained and untrained exercise performers on serum iron, blood haemoglobin and cardiac efficiency through quantified exercise on Harvard Steps. Methodology: The present study was carried out on 13 male medical students and compared it with 10 male athletes in the age group of 18 to 25 years at Dr. Sampurnanand Medical College, Jodhpur. The biochemical parameter was serum iron and hemodynamic parameters measured were hemoglobin, pulse rate and blood pressure in both the groups after overnight rest and after quantified bout of exercise for 5 minutes on Harvard step. Result: Serum iron fell from pre-exercise level and was more marked (P<0.01) in untrained. After exercise there was significant rise (P<0.001) of hemoglobin and pulse rate in untrained (P<0.001). A significant increase in systolic blood pressure in case of untrained boys (p<0.01) and athletes (p<0.001) was observed. Whereas decrease in diastolic blood pressure was observed in both the groups but decrease in diastolic blood pressure were more marked in athletes (P<0.001). Conclusion: Exercise induces improvement in hemodynamic status.
Sinwar P.D.,Sardar Patel Medical College
International Journal of Surgery Case Reports | Year: 2015
Introduction Traumatic auricular amputation due to human bite is not a common event. Bite wounds are always considered to be complex injuries contaminated with unique poly-microbial inoculum. Human bites are as serious as animal bites because they induce a higher incidence of infectious complications. In bite wounds to the face, infectious complications can create more difficulties than the initial tissue damage itself for the task of restoring an aesthetic appearance.Presentation of case In this case report a young male patient had ear lobule injury on interpersonal violence and amputation of ear lobule results. Due to delay in presentation and high chances of infection wound healing by secondary intention achieved.Discussion Microsurgery can be performed in some cases, but most microsurgical techniques are complex and their use can only be advocated in specialized centers.Conclusion Oversight may result in a potentially devastating complication involving function, infection or cosmesis. © 2014 Published by Elsevier Ltd.
Soni Y.,Sardar Patel Medical College |
Rajnee,Sardar Patel Medical College
JPMI - Journal of Postgraduate Medical Institute | Year: 2011
Objectives: To compare the effect of Guar fiber in Roasted and cooked vegetable form on lipid profile in diabetic as well as in normal healthy subjects. Methodology: This study was conducted at Department of Medicine, Sardar Patel Medical College, Bikaner, India on 120 subjects in which 60 were diabetic and 60 non diabetic. Blood samples were withdrawn before and after 15 and 30 days of consumption of 10.0 and 20.0 gm of roasted and cooked guar fiber per day and analyzed for sugar, cholesterol, triglyceride, HDL, LDL and VLDL-cholesterol by standard technique using semi-autoanalyzer. Results: The Blood sugar, cholesterol, triglyceride, LDL and VLDL showed highly significant results (t=4.33 & p<.001)after supplementation of roasted guar fiber for 30 days as compare to that of cooked vegetable guar fiber in normal as well as in diabetic subjects in daily routine diet, Blood sugar level(96.9 ± 2.49%) after 30 days consumption of 20 gm roasted guar fiber per day in normal subjects & in Diabetics (154.3 ±15.38%) where as HDL showed no significant change when 20 gm roasted fiber given for 15 days (49.7±7.10),after 30 days range is (55.5±8.16),p value(p<.05). Conclusions: Roasted guar, as compared to cooked guar, significantly reduces Blood sugar,serum cholesterol,triglyceride,LDL and VLDL level not HDL, in both diabetic and non diabetic adults. Roasted guar fiber diet is beneficial for Diabetic as well as Cardiac patients.
PubMed | Sardar Patel Medical College and Navodaya Medical College
Type: Journal Article | Journal: Journal of pediatric neurosciences | Year: 2016
Neonatal sonography of the brain is now an essential part of newborn care, particularly in high risk and unstable premature infants. Cranial ultrasound is the most available and easily repeatable imaging technique for the neonatal brain showing brain development and the most frequently occurring forms of cerebral injury in the preterm and terms. This study aims to assess the importance of cranial ultrasound as an investigatory modality for high-risk neonates and to find out the morphology of various cerebral lesions and correlate clinically.An observational correlation clinical study was conducted at Sardar Patel Medical College, Bikaner involving 100 high-risk neonates admitted to Neonatal Intensive Care Unit (NICU) who was subjected to neurosonography on selected days as per protocol. Perinatal details were recorded, and clinical examination with appropriate investigations was done. The cranial ultrasound was done, and morphology of various findings was studied and recorded. Clinical correlation with cranial ultrasound findings and follow-up was done.On cranial ultrasound, 38% of neonates had abnormal findings. Twelve percent of these had evidence of intracranial bleed, 13% periventricular echogenicity, 7% had ventriculomegaly, 2% had cerebral edema, and 1% had leukomalacia. Three neonates had findings suggestive of simple cyst in middle cranial fossa, agenesis of corpus callosum, and choroid plexus cyst.Cranial ultrasonography is the best point of care neuroimaging method available for high-risk neonates. It is critical as an investigatory modality in NICU and effectively documents morphology of cerebral damage.
PubMed | Sardar Patel Medical College
Type: | Journal: Case reports in urology | Year: 2016
Herein, we present a case report of post-TURP (transurethral resection of prostate) recurrent severe hematuria due to right internal iliac artery pseudoaneurysm protruding into bladder lumen. A 60-year-old male presented with recurrent massive hematuria following TURP done elsewhere 15 days before. His hemoglobin was 4gm/dL after 13 units of blood transfusion and repeated clot evacuations. His blood urea, serum creatinine, and coagulation profile studies were normal. Ultrasonography of abdomen showed multiple clots in the bladder. Cystoscopy revealed clots with a right posterolateral wall unhealthy area. After stabilizing the patient, contrast enhanced CT urography revealed intravesical aneurysm. CT angiography showed pseudoaneurysm of a branch of internal iliac artery protruding into urinary bladder lumen. We referred patient to selective embolization of the lesion but the procedure was unsuccessful. At last, ipsilateral internal iliac artery ligation relieved hematuria. But on postoperative day 2, patient suddenly collapsed and deceased, presumably due to cardiomorbidities.
PubMed | Sardar Patel Medical College and Navodaya Medical College
Type: Journal Article | Journal: Journal of neonatal-perinatal medicine | Year: 2016
This study was carried out to determine the incidence, clinical features, etiology and outcome of functional and intrinsic acute kidney injury (AKI) in preterm neonates.This is a prospective observational study on premature infants admitted to the neonatal intensive care unit (NICU) over an eight month period. All biochemical parameters of renal function tests were monitored and statically analyzed.The study included 450 infants; of them 300 were inborn and 150 infants were outborn and transported to the NICU. Mean gestational age, weight, and age at the time of AKI diagnosis were 32.3 weeks, 1.66kg and 3.23 days respectively. The male: female ratio was 1.84:1. Incidence of AKI was higher in low birth weight babies. Sluggishness and refusal for feed were most common symptoms. Birth asphyxia and septicemia were the most common early and late cause of AKI. Hyponatremia was the most common electrolyte disturbance. The incidences of AKI, functional renal failure, and intrinsic renal failure were 12%, 48.14%, and 51.85% respectively.AKI is not uncommon in preterm infants. The early recognition and aggressive management of episodes of shock which often precede AKI could be life-saving.