Shaheed Hasan Khan Mewati Government Medical College
Shaheed Hasan Khan Mewati Government Medical College
Kaur A.D.,Maulana Azad Medical College |
Tyagi A.,Shaheed Hasan Khan Mewati Government Medical College
Journal of Indian Academy of Forensic Medicine | Year: 2016
Negligence is a pre-condition for fastening any liability on a medical practitioner for damages and compensation. In comparison with the other fields of medicine, litigations in obstetrics and radiology are very common now-days and one such example is in antenatal screening procedures. Neural tube defects are common birth defects with a prevalence of 4-5 cases per 10,000 live births. Prenatal diagnosis of neural tube defects has implications in obstetric management whereby early detection and if needed, the termination of pregnancy could successfully reduce their incidence. The majority of claims involving neural tube defects involve allegations of delayed diagnosis. This present case of a child who was born subsequent to missed diagnosis of neural tube defects with complications, despite vigilant antenatal checkups and serial ultrasound scans which were taken up by her mother. This was considered as failure on the part of radiologist in detecting neural tube defect which could have been detected as late as 14-16 weeks. Here, we have discussed neural tube defects, their diagnosis and their medico-legal aspects.
Agrawal Y.,Shaheed Hasan Khan Mewati Government Medical College |
Goyal V.,Shaheed Hasan Khan Mewati Government Medical College |
Singh A.,Shaheed Hasan Khan Mewati Government Medical College |
Lal S.,Lady Hardinge Medical College
Journal of Clinical and Diagnostic Research | Year: 2017
Introduction: Both pulmonary Tuberculosis (TB) and anaemia are prevalent in India. Magnesium levels also influence TB. There is limited and inconsistent literature on the association among anaemia, serum magnesium levels and sputum conversion during tuberculosis treatment. Aim: To study the effect of anaemia and serum magnesium levels on sputum conversion in pulmonary TB patients. Materials and Methods: One hundred each of newly diagnosed sputum smear positive Pulmonary Tuberculosis (PTB), sputum smear negative PTB patients initiated on Directly Observed Treatment Short Course chemotherapy (DOTS) and healthy age and sex matched controls were recruited in the study. Patients were followed up prospectively until completion of first two months of intensive phase. Patients were evaluated before initiation of TB treatment by performing the complete blood counts with peripheral blood smear, serum biochemistry, serum iron, serum magnesium, serum ferritin and microscopic examination of sputum. After giving two months of Antitubercular Therapy (ATT), sputum smears were re-examined for presence of acid fast bacilli. Haemoglobin values less than 13 g/dl in males or 12 g/dl in females was defined as anaemia. Mean and Standard deviations were calculated. Independent t-test was used to compare between the groups. Results: Serum iron and serum ferritin was significantly lower in sputum positive PTB as compared to sputum negative PTB and controls. Anaemia was present in 162 (81%) patients of the study PTB cases. About 60% of anaemia in sputum positive cases was iron deficiency anaemia. Serum magnesium level was significantly lower in sputum positive PTB as compared to sputum negative PTB and controls though not in hypomagnesemic range. Delayed sputum smear conversion occurred in 12 (12%) sputum positive PTB patients. Of these, eight had severe iron deficiency anaemia, four with moderate anaemia. All 12 delayed sputum smear conversion had serum magnesium levels < 1.7 mg/dl (below normal reference range) (mean 1.42 +0.22 mg/dl). Conclusion: Sputum was found to be positive even after two months of ATT course because of baseline anaemia and lower levels of serum magnesium. Further multicentric studies are warranted to study mechanisms for TB associated anaemia and possible role of intervention for anaemia in TB patients. One needs to find out the mechanisms behind the role of anaemia and lower magnesium levels in delaying the sputum smear conversion in order to lay the foundation of effective interventions. Randomized controlled trials are warranted to generate higher levels of evidences to support our findings. © 2017, Journal of Clinical and Diagnostic Research. All rights reserved.
Imran M.,Pacific Institute of Medical science |
Amir M.,Shaheed Hasan Khan Mewati Government Medical College |
Naqvi H.,Jamia Hamdard University |
Naaz S.,Hamzah Imran Medical and Educational Trust
International Journal of Green Pharmacy | Year: 2017
Introduction: The study was conducted to evaluate the drug utilization pattern of Ayurveda, Unani medicines and folk medicine in comparison to the drug from the modern system (allopathy system) in rural areas of Mewat, Haryana. Materials and Methods: The study was cross-sectional questionnaire-based community survey. The 300 healthy adult male volunteers more than 18 years of age participated in the survey in city Nuh of the district Mewat after obtaining the oral consent. All the participants were literate. Main Outcome Measures: The participants were asked about the experiences with complementary and alternative medicine (CAM) medications in four different categories. Firstly; their preferences for using Ayurvedic, Unani, herbal, dietary supplements, home remedies or any other external preparation for disease. Second, whether they took the medicine by their own initiative, AYUSH doctor, Pharmacist and on recommendation of any other friend and family members. Third, perceived experiences of the medication taken as effects, side effects and do not know. Fourth, the conditions for which the medication was taken. Results: There was widespread utilization of Ayurveda (62%), Unani (74%) and other traditional therapies (76%) alternatively or complementarily for the different afflictions. The CAM was preferred by 60% of the respondents and 71% consider it to be more effective over allopathy. The majority (83%) sought the CAM treatment on family and friend's recommndations. Conclusions: The CAM therapies have more acceptability in the general public because of their perceived high safety, lesser cost and accessible to the general public. However, the health-care infrastructure for providing acceptable CAM therapy is still lacking.
Satarkar R.N.,Shaheed Hasan Khan Mewati Government Medical College |
Srikanth S.,Prathima Institute of Medical science
Indian Journal of Cancer | Year: 2016
INTRODUCTION: The nasal cavity, paranasal sinuses, and nasopharynx though in continuity form a complex system of upper respiratory tract; this region is endowed with a variety of elements such as epithelial, glandular, lymphoid, cartilage, and bone and is also exposed to a variety of infections, tumor-like and true neoplastic conditions. AIMS AND OBJECTIVES: To find out the frequency of various tumors and tumor-like conditions of the nasal cavity, paranasal sinuses, and nasopharynx. MATERIALS AND METHODS: The present study is an analysis of 206 tumors and tumor-like conditions of the nasal cavity, paranasal sinuses, and nasopharynx diagnosed during a period of 5 years. RESULTS: The patients' age ranged from 14 months to 85 years. Benign lesions were predominant in the second and third decades, with 30 cases (68.1%) occurring in that age group. Malignancies occurred predominantly in the sixth and seventh decades with 28 (60.9%) cases in this age group. Benign lesions in the nasopharynx comprised 75% cases and malignancies 25%. Eighty-Three (71.5%) tumor-like conditions occurred in the nose and antrochoanal region. CONCLUSION: Angiofibroma was the most common benign tumor accounting for 25.55% of all neoplastic lesions. Squamous cell carcinoma was the most common malignancy at this site constituting 50% of all malignancies. © 2017 Indian Journal of Cancer.
PubMed | Army Hospital Research & Referral, Government Medical College and Shaheed Hasan Khan Mewati Government Medical College
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2014
Pancreatic endocrine tumours are rare in occurrence. They may present with a baffling range of symptoms which pose a diagnostic dilemma. Two cases of pancreatic insulinoma are presented herewith. Both presented with neuro-psychiatric complaints and were treated symptomatically for depression, anxiety, seizures etc. The diagnosis in these patients was missed for years. Insulinoma being a great diagnostic challenge, requires reasonably high clinical suspicion, accurate biochemical diagnosis and radiological localization to avoid extensive surgery. The aim is to highlight the occurrence of this rare tumour at a tertiary care hospital.
PubMed | NIMS Medical College & Hospital, Shaheed Hasan Khan Mewati Government Medical College, JSS Medical College, Post Graduate Institute of Medical Education and Research and 9 more.
Type: Journal Article | Journal: The International journal of social psychiatry | Year: 2016
To assess the phenomenology and associated beliefs in patients with Dhat syndrome.A total of 780 male patients aged more than 16 years were recruited from 15 centers spread across the country and were assessed on Dhat Syndrome Questionnaire.The most commonly reported reasons for passage of Dhat were excessive masturbation (55.1%), sexual dreams (47.3%), excessive sexual desire (42.8%) and consumption of high energy foods (36.7%). The most common situation in which participants experienced passage of Dhat were as night falls (60.1%) and while passing stools (59.5%). The most common consequence due to passage of Dhat was weakness in sexual ability (75.6%). In terms of psychological and somatic symptoms, the common symptoms included bodily weakness (78.2%); feeling tired or having low energy (75.9%); feeling down, depressed, or hopeless (67.9%); and little interest or pleasure in doing things (63.7%). In terms of treatment expectations, about half of the patients (49.1%) expected that energizing medications like vitamins/tonics/tablets were required and more than one-third (38.2%) expected that there was a need for taking energizing injections.Present study shows that Dhat syndrome is a distinct clinical entity seen all over India, with its characteristic features.
PubMed | Teerthanker Mahaveer Medical College and Research Center, Kasturba Medical College, Shaheed Hasan Khan Mewati Government Medical College and All India Institute of Medical Sciences
Type: Journal Article | Journal: The Malaysian journal of medical sciences : MJMS | Year: 2016
Surrogate markers simple enough to be used by primary care workers have not been closely investigated by the community experts in rural Uttar Pradesh. We assessed the physical disabilities in activities of daily living (ADL) and unmet need in physical disabilities among rural elderly. Predictors of unmet needs in physical disabilities among the elderly were also identified.A community based cross-sectional study was conducted among elderly residents of the rural field practice area of a tertiary care centre in rural Uttar Pradesh. Three hundred and thirty five (335) participants aged 60 years and above from 9 villages were selected using the Probability Proportional to Size (PPS) sampling technique. Study tools were the proforma regarding socio-demographic details, socio-economic status and Stanford Health Assessment Questionnaire. Multivariate logistic regression analysis was performed to identify predictors of unmet needs.185 (55.2%) had physical disability in one or more activity limitation. Gender wise elderly females had more physical disability in one or more ADL categories than elderly males (66.8% vs. 42.0%). Almost one third (32.5%) of subjects had unmet need for one or more physical disabilities. the predictors of unmet needs that were identified in the study were female gender (The findings of the study highlight that large number of needs of the disabled are still unmet. Greater, targeted efforts are needed to identify at-risk elderly people living in the community. These predictors would act as surrogate markers and can be easily used by primary care workers to plan and provide services to the elderly people in rural communities.
PubMed | Lady Hardinge Medical College, Pt. B.D. Sharma PGIMS and Shaheed Hasan Khan Mewati Government Medical College
Type: Journal Article | Journal: Journal of family medicine and primary care | Year: 2014
To strengthen the surveillance system in India, Integrated Disease Surveillance Program (IDSP) was launched in 2004. The frequent occurrence of epidemics even after the launching of the IDSP was an indication toward inadequacy of the system. The responsibility for effective implementation of IDSP at the sub-center level lies with the health workers.The aim of the following study was to assess the knowledge and practice of health workers regarding IDSP and to assess the quality of IDSP reports at the sub-center level.It was cross-sectional study carried out in the area under Community Health Center Dighal which is the rural field practice area attached to Post Graduate Institute of Medical Sciences, Rohtak in the State of Haryana, India.All the 24 sub-centers in the area were visited and 46 health workers (22 male; 24 female) who met the inclusion criteria i.e. who had completed 1 year of their service or had been trained for IDSP, were included in the study. Data were collected on a self-designed, semi-structured and pre-tested schedule by interviewing the study subjects and observation of the records/reports.Percentages and proportions.Only 14/46 (~30%) of the workers could expand the abbreviation IDSP correctly. Only 4/46 (~9%) workers could narrate any of the trigger events and none could tell all the trigger events. Only at 12 such sub-centers, diagnoses were being written in their out-patient registers according to the defined syndromes. 43/46 (~93%) workers were not aware of the zero reporting.The surveillance system is much less alert and intense than the desired level and needs to be strengthened.
PubMed | Sanjay Gandhi Post Graduate Institute of Medical Sciences, Shaheed Hasan Khan Mewati Government Medical College and Government Medical College
Type: Journal Article | Journal: Avicenna journal of medicine | Year: 2015
The association of hypothyroidism with impairment of hearing is known to occur. It may be of any kind i. e., conductive, sensorineural or mixed. The aim of this study is to assess auditory pathway by brainstem auditory evoked potential (BAEP) in newly diagnosed patients of clinical hypothyroidism and healthy sex- and age-matched controls.The study included 25 healthy age- and sex-matched controls (Group I) and 25 patients of newly diagnosed clinical hypothyroidism (Group II). The recording was taken by using RMS EMG EP MK2 equipment.Unpaired Students t test.There was a significant increase in wave IV (5.16 0.85 ms) and wave V (6.17 0.89 ms) latencies of right ear BAEP of Group II in comparison to wave IV (4.66 0.39 ms) and wave V (5.49 0.26 ms) of Group I. Wave V of left ear BAEP of Group II was also prolonged (6 0.61 ms) in comparison to Group I (5.47 0.35 ms). There was a significant difference in inter-peak latencies IPL I -V (4.44 0.66 ms) and IPL III -V (2.2 0.5 ms) of right ear BAEP of Group II in comparison to IPL I -V (3.94 0.31 ms) and IPL III -V (1.84 0.34 ms) of Group I. A significant prolongation was also found of IPL I -V (4.36 0.59 ms) and IPL III -V (2.2 0.42 ms) of left ear BAEP of Group II in comparison to IPL I -V (3.89 0.3 ms) and IPL III -V (1.85 0.3 ms) of Group I.Prolongation of wave IV and V along with inter-peak latencies in BAEP of both ears suggests that central auditory pathway is affected significantly in clinical hypothyroid patients.
PubMed | Shaheed Hasan Khan Mewati Government Medical College
Type: Journal Article | Journal: Anesthesia, essays and researches | Year: 2015
Tetanus is an acute often fatal disease produced by gram positive obligate anaerobic bacterium Clostridium tetani. Tetanolysin damages local tissue and provides optimal conditions for bacterial multiplication. It is therefore important to perform a wide debridement of any wound suspected of being a portal of entry for the bacteria. Little evidence exists to recommend specific anesthetic protocols. We encountered a child scheduled for fracture both bone forearm with developing tetanus. Initial management done with intravenous (i.v) diazepam, phenobarbitone, and metronidazole. After premedication with midazolam and fentanyl, induction was done by propofol 60 mg, vecuronium 2.5 mg, ventilated with O2+ N2O 50:50 with sevoflurane 2% and tracheal intubation was done with 5.5 ID cuffed PVC endotracheal tube. Anesthesia was maintained with sevoflurane 2% and vecuronium intermittently when required. Intraop vitals were stable. On completion of surgery, reversal given and patient was extubated uneventfully and shifted to recovery room. Little evidence exists to recommend specific anesthetic technique for tetanus patient posted for surgery. When present, obvious wounds should be surgically debrided. Ideally patients considered for surgery should undergo anesthesia and surgery before severe autonomic dysfunction develops. Most anesthetic managements are based on limited evidence. However, we used sevoflurane and vecuronium successfully, further study is needed to establish their efficacy and safety. Major challenges lie in the control of muscle rigidity and spasm, autonomic disturbances and prevention of complications.