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Oberoi D.V.,SGRR Institute of Medical and Health science | Pradhan C.,National Institute of Mental Health and Neuro Sciences | Jairaj Kumar C.,NITTE University | D'Souza S.C.,Manipal University India
Australasian Medical Journal | Year: 2010

Background: In diabetic individuals (DI), neuropathy hinders the redistribution of plantar pressure points thus leading to susceptible areas where there is constant capillary blanching which may develop into trophic ulcers. The redistribution of pressure points may precede evidence of clinical neuropathy. In this study we compare temporal redistribution of plantar pressure points (areas of capillary blanching) between normal subjects taken as controls and DI with no clinical signs of neuropathy. Method: Four adults (45±4.55 years) diagnosed to have Type-2 Diabetes, without signs of clinical neuropathy and age -matched controls (43±3.74 years) were studied. The subjects were asked to stand on a glass slab and a 10 minute video recording of 10 selected plantar pressure points was made. Changes in the distance of these points with reference to a defined point on Mayer's line were measured at every 10 seconds. Standard deviation of difference of redistributed consecutive pressure point (SDPP) in cms., and fractal dimension (FD) was used to compare the two groups. Results: Combined mean SDPP (DI =0.013 ± 0.008 cms, controls= 0.196±0.233 cms, P <0.001) and FD (DI =1.000 ± 0.000, controls= 1.010±0.017, P <0.001) of diabetic patients were significantly lower than controls. Pressure point at base of the 4th toe and the lower limit of blanching to the left Mayers line at the heel did not differ significantly between DI and controls. Conclusion: There is impaired redistribution of plantar pressure points in individuals with diabetes without signs of clinical neuropathy. This can be attributed to loss of chaos generating mechanisms in DI. Redistribution of pressure points may be essential in the prevention of trophic ulcers in susceptible individuals.

Azad R.,SGRR Institute of Medical and Health science | Magu S.,Pt. B.D.S | Gathwala G.,Pt. B.D.S
Journal of Clinical and Diagnostic Research | Year: 2012

Objective: To create the reference standards for the thymic size by sonography in healthy neonates in the north Indian population and to assess the variation in its location, echogenicity and echopattern. Material and Methods: This study was done prospectively on 200 healthy term neonates from north India at less than one week of age. The size of the thymus was measured in terms of the transverse diameter, the sagittal area, the thymic index and the anteroposterior (AP) diameter and the normal reference standards were created. The thymus was assessed in terms of its location, echogenicity (done in terms of the relative echogenicity number) and echopattern. The comparison of the thymic echogenicity and the echopattern with that of the liver, spleen and the thyroid was also performed. Results: The range of the thymic transverse diameter was 1.6-4.2 cm (mean 2.68 ± 0.54), that of the sagittal area was 1.31-5.13 cm2 (mean 3.01 ± 0.74), that of the thymic index was 2.60-16.93 cm3 (mean 8.10 ±2.74), that of the AP (Right) was 0.50-2.30 cm (mean 1.27 ± 0.35), that of the AP (left) was 0.20-2.90 cm (mean 1.72 ±0.4) and that of the AP (mean) was 0.40-2.35 cm (mean 1.49 ± 0.33). The thymus was located in the supero-anterior mediastinum and it was less echogenic than the liver, spleen and the thyroid. In majority of the subjects, the thymus was coarser in echo pattern than the spleen. However, it resembled or was coarser than the liver and the thyroid in almost equal proportions. Conclusion: The normative standards of the thymic size and the thymic appearance in a given population are useful in assessing this complex lymphoid organ sonographically in health and disease and also to carry out various immunological studies.

Singh R.,University of Lucknow | Sharma S.,SGRR Institute of Medical and Health science | Singh R.K.,T S Misra Medical College and Hospital | Mahdi A.A.,University of Lucknow | And 2 more authors.
Clinica Chimica Acta | Year: 2016

Background: Circulating lipid components were studied under near-normal tropical conditions (around Lucknow) in 162 healthy volunteers - mostly medical students, staff members and members of their families (103 males and 59 females; 7 to 75 y), subdivided into 4 age groups: A (7-20 y; N = 42), B (21-40 y; N = 60), C (41-60 y; N = 35) and D (61-75 y; N = 25). Methods: Blood samples were collected from each subject every 6 h for 24 h (4 samples). Plasma was separated and total cholesterol, high-density-lipoprotein (HDL) cholesterol, phospholipids and total lipids were measured spectrophotometrically. Data from each subject were analyzed by cosinor. We examined by multiple-analysis of variance how the MESOR (Midline Estimating Statistic Of Rhythm, a rhythm-adjusted mean) and the circadian amplitude of these variables is affected by gender, age, diet (vegetarian vs. omnivore), and smoking status. Results: In addition to effects of gender and age, diet and smoking were found to affect the MESOR of circulating plasma lipid components in healthy Indians residing in northern India. Age also affected the circadian amplitude of these variables. Conclusion: These results indicate the possibility of using non-pharmacological interventions to improve a patient's metabolic profile before prescribing medication under near normal tropical conditions. They also add information that may help refine cut-off values in the light of factors shown here to affect blood lipids. © 2016 Elsevier B.V.

Saxena H.,SGRR Institute of Medical and Health science | Saxena A.P.,SGRR Institute of Medical and Health science
Indian Journal of Anaesthesia | Year: 2010

A case of acute poisoning with nitrobenzene is presented where clinical evaluation and timely management, with repeated intravenous methylene blue helped to save a life. It is important to take care of the secondary cycling of nitrobenzene from body stores in patients presenting late, after heavy exposure.

Kumar M.,SGRR Institute of Medical and Health science | Kumari R.,SGRR Institute of Medical and Health science | Nigam P.N.,Patna Medical College and Hospital
Journal of Clinical and Diagnostic Research | Year: 2014

Background: Status epilepticus (SE) is a common, life threatening neurologic disorder that is essentially an acute, prolonged epileptic crisis. SE can represent an exacerbation of a pre-existing seizure disorder, the initial manifestation of a seizure disorder, or an insult other than a seizure disorder. Objectives: To study the aetiology, clinical profile, and outcome of SE in pediatric age group. Setting and study design: Prospective study at a tertiary care medical college hospital in Bihar, India. Materials and methods: Study was carried out for a period of one year (from April 2008 to March 2009). Seventy patients of SE in the age group of 6 month to 12 years were included in the study. Clinical history, general and systemic examination and relevant investigations along with pretested questionnaire were used to categorise different variables. Independent t-test was used for continuous variables and chi-square test for categorical variables. Results: Mean age for the study population was found to be 5.94 years (SD=3.152). Preponderance of male (60%) over female (40%) was observed. Aetiology included Idiopathic (27.14%), remote symptomatic (20%), acute symptomatic (47.14%), febrile (2.86%) and progressive encephalopathy (2.86%) groups. Generalised tonic clonic convulsion (GTC) convulsion was observed in 91.4% of SE patients while 8.6% had partial SE. Eighteen patients (25.7%) had prior history of convulsion whereas 52 patients (74.3%) presented with SE as first episode of convulsion. In our study, mortality rate was found to be 31.4% and acute symptomatic causes were responsible for most of the deaths. Conclusion: SE is a severe life threatening emergency with substantial morbidity and mortality. Patients with younger age and male sex are slightly more vulnerable to develop SE. Longer duration of SE and acute symptomatic aetiologies are independent predictors for poor outcome.

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