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Bīkāner, India

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.

Pahuja K.,Sardar Patel Medical College | Agarwal S.K.,JLN Medical College
Journal of the Anatomical Society of India | Year: 2012

In a psychiatric diagnosis, Schizophrenia [schizein ("to split") and phren-("mind")] is a mental illness. The neurodevelopment theory of the etiology of schizophrenia, suggest either genetically or epigenetically controlled faulty embryonic development of structures of ectoderm origin like brain and skin. This may disturb neurodevelopment that in turn may cause these subjects to be at increased risk for the development of schizophrenia and related disorders. Dermatoglyphics is used as a diagnostic aid in a number of diseases that have a strong hereditary basis. In the present work, we studied the frequencies of various types of skin ridges found on the digits, palms in schizophrenic patients. The present study aimed to evaluate the association of dermatoglyphic patterns with different blood groups and also to evaluate the role of dermatoglyphics in early detection of prone individuals and genetic predisposition of disease. Studies were conducted in 100 patients of schizophrenia and various dermatoglyphics parameters such as finger print pattern and exits of main lines were calculated. These parameters of study group were compared to controls. Qualitative analysis has shown statistically significant difference among two groups. It was observed that in blood group A the Arche pattern in both hands were pre-dominant when compared those of controls and the difference was highly significant (P< 0.05) while loop ulnar pattern was highly significant (P<0.001). Loop ulnar pattern was highly significant (P<0.001) in left hand of blood group AB. The main line index in the study group when compared to controls observed the difference. © 2012 Anatomical Society of India.

Bhaya M.,Pediatric and Adult Cardiology | 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.

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.

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.

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