SGRD Institute of Medical science and Research

Amritsar, India

SGRD Institute of Medical science and Research

Amritsar, India
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Natt N.K.,SGRD Institute of Medical science and Research | Gupta A.,Government of Punjab | Singh G.,Government of Punjab | Singh T.,SGRD Institute of Medical science and Research
Indian Journal of Ophthalmology | Year: 2014

Aims: The aim was to compare efficacy and cost-effectiveness of bimatoprost 0.03% and brimonidine 0.2% in primary open-angle glaucoma (POAG)/ocular hypertension (OHT). Settings and Design: Open, randomized, cross-over, comparative study. Materials and Methods: Forty patients of POAG or OHT with intraocular pressure (IOP) <30 mm Hg were included in the study after a written informed consent. The patients were divided randomly into two groups of 20 patients each. Patients of group A were administered bimatoprost 0.03% eye drops once daily, and those of group B brimonidine 0.2% eye drops twice daily for a period of 4 weeks. After a washout period of 4 weeks, the patients were crossed over that is, group A was administered brimonidine 0.2% and group B bimatoprost 0.03%. Fall in IOP at 4 weeks was recorded. The daily cost of each drug was calculated by maximum retail price and the average number of drops per bottle. The cost-effectiveness was then calculated as the cost of drug/mm Hg fall in IOP. Statistics: Independent samples t-test was used to compare the efficacy of both drugs. Results: IOP lowering with bimatoprost (8.9 ± 1.598 mm Hg) was significantly (P < 0.0001) higher than brimonidine (6.55 ± 1.26 mm Hg). The number of drops/ml were 33.43 ± 0.52 and 25.49 ± 0.26, respectively, for bimatoprost and brimonidine. Treatment with bimatoprost was costlier than brimonidine with daily costs/eye Rs. 4.02 ± 0.06 and 3.14 ± 0.03, yearly costs/eye Rs. 1467.46 ± 20.74 and 1147.75 ± 11.15, respectively. Bimatoprost was more cost-effective than brimonidine with the cost-effectiveness ratio (CER) respectively Rs. 13.10 ± 2.61/mm Hg and Rs. 13.96 ± 2.86/mm Hg. Incremental CER Rs. 10.43/mm Hg implies lower costs/mm Hg extra IOP lowering by bimatoprost than Rs. 13.96 for brimonidine. Conclusion: In spite of being costlier, bimatoprost is more efficacious and cost-effective than brimonidine.


Kumar S.,Dasmesh Institute of Research and Dental Science | Prabhakar V.,Dasmesh Institute of Research and Dental Science | Rao K.,SGRD Institute of medical science and research | Brar R.,Dasmesh Institute of Research and Dental Science
Indian Journal of Otolaryngology and Head and Neck Surgery | Year: 2011

Standard treatment of mandibular angle fracture with miniplates according to recommendations of Champy et al. (1976) consists of fixation with one miniplate at superior border of mandible ventral to external oblique line. In certain constellations, second miniplate at lower border may provide additional stability. In this retrospective study 80 patients with mandibular angle fracture were divided into 3 sub-groups reported at DIRDS Faridkot were treated by intraoral, extraoral and combined intraoral and transbuccal approach. There was no significant difference in complication rates encountered with these techniques. Decision regarding treatment approaches for open reduction of mandible fracture often relates to surgeon's experience and training. In some cases, choice is affected by availability of equipment. More difficult cases involving endentulous atrophic mandible or comminution should be considered for extraoral approach. Intraoral open reduction and fixation was used for non-comminuted and non-complicated fractures. The combined transbuccal/Intraoral procedure is now preferred method because of ease of use and facilitation of placement of plate in neutral mid point area of mandible. © 2011 Association of Otolaryngologists of India.


Singh K.,SGRD institute of Medical science and Research | Singh N.,Dayanand Medical College and Hospital | Thukral C.L.,SGRD institute of Medical science and Research | Singh K.P.,SGRD institute of Medical science and Research | Bhalla V.,SGRD institute of Medical science and Research
Journal of Clinical and Diagnostic Research | Year: 2014

Aims: The purpose of the study was to evaluate the role of Magnetic Resonance Imaging in detection and characterization of perianal fistulae and correlating it with surgical findings. Methods: Fifty consecutive patients with suspected perianal fistulae having one or more external openings were prospectively selected for MRI evaluation. Previously operated or patients with recurrent perianal disease were excluded from the study. MRI findings were recorded according to "St. James's University Hospital MR Imaging Classification of Perianal Fistulae" and correlated with surgical observations. Finally, comparison between T2-weighted fat saturated and postcontrast T1-weighted fat saturated sequences was done. Results: Amongst the total of 50 patients, per-operative findings confirmed perianal fistulae in 45 patients. The sensitivity and specificity of MRI in correctly detecting and grading the primary tract was found to be 95.56% and 80% respectively; for abscess, it was 87.50% and 95.24% respectively. High sensitivity was also discerned in identification of secondary tract (93.75%), correct localization of internal opening (95.83%) and for correctly detecting the horse-shoeing (87.50%). Our assumption of null hypothesis was accepted on comparing results of T2-weighted fat saturated sequences and postcontrast T1-weighted fat saturated sequences. Conclusion: Magnetic Resonance Imaging (MRI) was highly accurate in assessment of surgically important parameters (primary tract and its grading, internal opening, secondary tract, abscess, horseshoeing) of perianal fistulae. Comparison of results of imaging findings on T2-weighted and postcontrast T1-weighted fat saturated sequences were statistically similar, so contrast study can be omitted, particularly while evaluating primary/previously unoperated perianal fistulae.


PubMed | SGRD institute of Medical science and Research and Dayanand Medical College and Hospital
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2014

The purpose of the study was to evaluate the role of Magnetic Resonance Imaging in detection and characterization of perianal fistulae and correlating it with surgical findings.Fifty consecutive patients with suspected perianal fistulae having one or more external openings were prospectively selected for MRI evaluation. Previously operated or patients with recurrent perianal disease were excluded from the study. MRI findings were recorded according to St. Jamess University Hospital MR Imaging Classification of Perianal Fistulae and correlated with surgical observations. Finally, comparison between T2-weighted fat saturated and postcontrast T1-weighted fat saturated sequences was done.Amongst the total of 50 patients, per-operative findings confirmed perianal fistulae in 45 patients. The sensitivity and specificity of MRI in correctly detecting and grading the primary tract was found to be 95.56% and 80% respectively; for abscess, it was 87.50% and 95.24% respectively. High sensitivity was also discerned in identification of secondary tract (93.75%), correct localization of internal opening (95.83%) and for correctly detecting the horse-shoeing (87.50%). Our assumption of null hypothesis was accepted on comparing results of T2-weighted fat saturated sequences and postcontrast T1-weighted fat saturated sequences.Magnetic Resonance Imaging (MRI) was highly accurate in assessment of surgically important parameters (primary tract and its grading, internal opening, secondary tract, abscess, horseshoeing) of perianal fistulae. Comparison of results of imaging findings on T2-weighted and postcontrast T1-weighted fat saturated sequences were statistically similar, so contrast study can be omitted, particularly while evaluating primary / previously unoperated perianal fistulae.


Rao K.,SGRD Institute of Medical science and Research | Goyal V.P.,RNT Medical college
Indian Journal of Otolaryngology and Head and Neck Surgery | Year: 2010

To study the FNAC and histopathological pattern of thyroid swelling, prevalence of thyroid malignancy, mode of treatment and associated surgical complications. A total of 100 patients of thyroid swelling were evaluated by FNAC preoperatively and histopathologically after surgery. Reports of FNAC and histopathology were similar in 73% patients while dissimilar in 27%. Among benign tumors diffuse colloid goiter was the most common presentation. Thyroid disease is endemic and colloid goiter is the most common presentation. FNAC is useful in preoperative planning but final diagnosis should be based upon histopathology. © 2011 Association of Otolaryngologists of India.


Rao K.,Sgrd Institute Of Medical Science And Research | Kumar S.,Institute of Dental science
Indian Journal of Otolaryngology and Head and Neck Surgery | Year: 2014

The purpose of this study was to evaluate the use of enucleation and chemical cauterization in the management of odontogenic keratocyst (OKC) of the jaw. This study involves the retrospective review of 32 patients (20 males and 12 females) with 34 biopsy proven odontogenic keratocysts. All patients received a combination of enucleation and chemical cauterization with every time freshly prepared Carnoy's solution (absolute alcohol 6 mL, chloroform 3 mL, glacial acetic acid 1 mL, ferric chloride 0.1 gm/mL). None of these patients were diagnosed with basal cell nevus syndrome. Four of these patients did not give the follow up and were not included in the study. A total of 30 biopsy proven OKC were resolved with this treatment method. Post-operative follow up consists of clinical and radiographic examination. Follow up time ranged from a minimum of 2 years to a maximum of 5 years. Mean follow up was of 2.8 years. Recurrence rate of 5.8% was observed. Hence, concluded that the combination of enucleation and chemical cauterization may offer patients improved therapy in the management of odontogenic keratocysts of the jaws. © 2012 Association of Otolaryngologists of India.


Batra A.P.S.,SGRD Institute of Medical science and Research | Mahajan A.,SGRD Institute of Medical science and Research | Gupta K.,Chakitsa Hospital
Indian Journal of Plastic Surgery | Year: 2010

Smile is one of the most natural and important expressions of human emotion. Man uses his lips mainly to register his emotions. Thus, the slightest asymmetry or weakness around the lips and mouth may transform this pleasant expression into embarrassment and distortion. The circumoral musculature, the major part of which is supplied by the marginal mandibular branch of the facial nerve, is the main factor in this expression. Therefore, an injury to this nerve during a surgical procedure can distort the expression of the smile as well as other facial expressions. This nerve often gets injured by surgeons in operative procedures in the submandibular region, like excision of the submandibular gland due to lack of accurate knowledge of variations in the course, branches and relations. In the present study, 50 facial halves were dissected to study the origin, entire course, termination, branches, muscles supplied by it, its anastomoses with other branches of facial nerve on the same as well as on the opposite side and its relations with the surrounding structures. The marginal mandibular branch of the facial nerve was found superficial to the facial artery and (anterior) facial vein in all the cases (100%). Thus the facial artery can be used as an important landmark in locating the marginal mandibular nerve during surgical procedures. Such a study can help in planning precise and accurate incisions and in preventing the unrecognized severance of this nerve during surgical procedures.


Kiran Rao,Sgrd Institute Of Medical Science And Research | Sudesh Kumar,Institute of Dental Science
Gujarat Journal of Otorhinolaryngology and Head and Neck Surgery | Year: 2012

Nasorespiratory function and its relation to craniofacial growth is of great practical concern. Adenoid hypertrophy can cause nasal obstruction leading to mouth breathing which in turn cause a narrow maxillary dental arch and a high arched palate. There is a striking lack of scientific studies which make critical evaluation of this hypothesis difficult. Having the opinion of both dental surgeon and otorhinolaryingologist, we can see the strength of argument that adenoid obstruction can affect dentofacial structure. Here we present the study of 60 cases of adenoid hypertrophy. The aim of this study is to reveal both passionate support of and opposition to the hypothesis.


PubMed | SGRD Institute of Medical science and Research
Type: Journal Article | Journal: Indian journal of ophthalmology | Year: 2015

The aim was to compare efficacy and cost-effectiveness of bimatoprost 0.03% and brimonidine 0.2% in primary open-angle glaucoma (POAG)/ocular hypertension (OHT).Open, randomized, cross-over, comparative study.Forty patients of POAG or OHT with intraocular pressure (IOP) <30 mm Hg were included in the study after a written informed consent. The patients were divided randomly into two groups of 20 patients each. Patients of group A were administered bimatoprost 0.03% eye drops once daily, and those of group B brimonidine 0.2% eye drops twice daily for a period of 4 weeks. After a washout period of 4 weeks, the patients were crossed over that is, group A was administered brimonidine 0.2% and group B bimatoprost 0.03%. Fall in IOP at 4 weeks was recorded. The daily cost of each drug was calculated by maximum retail price and the average number of drops per bottle. The cost-effectiveness was then calculated as the cost of drug/mm Hg fall in IOP.Independent samples t-test was used to compare the efficacy of both drugs.IOP lowering with bimatoprost (8.9 1.598 mm Hg) was significantly (P < 0.0001) higher than brimonidine (6.55 1.26 mm Hg). The number of drops/ml were 33.43 0.52 and 25.49 0.26, respectively, for bimatoprost and brimonidine. Treatment with bimatoprost was costlier than brimonidine with daily costs/eye Rs. 4.02 0.06 and 3.14 0.03, yearly costs/eye Rs. 1467.46 20.74 and 1147.75 11.15, respectively. Bimatoprost was more cost-effective than brimonidine with the cost-effectiveness ratio (CER) respectively Rs. 13.10 2.61/mm Hg and Rs. 13.96 2.86/mm Hg. Incremental CER Rs. 10.43/mm Hg implies lower costs/mm Hg extra IOP lowering by bimatoprost than Rs. 13.96 for brimonidine.In spite of being costlier, bimatoprost is more efficacious and cost-effective than brimonidine.


PubMed | SGRD Institute of Medical science and Research
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2015

High Resolution Computed Tomography (HRCT), a modification of routine CT, provides a direct visual window in the temporal bone providing minute structural details. Purpose of the present study was to evaluate the normal variations, pathological processes (infections and congenital anomalies) and their extent involving the temporal bone along with their complications on HRCT and to correlate these imaging findings surgically, wherever available.The prospective study included 50 patients who were referred to the radiology department with clinically suspected temporal bone or ear pathologies. After detailed clinical examination, the patients were subjected to high resolution computed tomography (HRCT) examination. The imaging findings were correlated with the surgical findings wherever available. The surgical findings were considered as final.From a total of 50 cases, 83.33% had cholesteatoma. The surgical and radiological findings showed a high level of sensitivity (89.29%) in the identification of cholesteatoma. HRCT provides a good sensitivity of 80.65% in the identification of changes to the ossicular chain despite the presence of surrounding soft tissue. HRCT was highly informative in identification of erosion of lateral semicircular canal. In diagnosis of facial canal dehiscence HRCT had a low sensitivity of 33.33%. In the evaluation of any congenital abnormality of the ear HRCT proved to be beneficial in depicting the anatomical details.The clinical and radiological findings showed a high level sensitivity with intraoperative findings as regards to the presence of cholesteatoma, changes of the ossicular chain and erosion of the lateral semicircular canal. HRCT findings, in the treatment of any congenital abnormality of the ear were a good guide to the surgeon for planning and management.

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