SHKM Government Medical College

Haryana, India

SHKM Government Medical College

Haryana, India
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Singh H.,PGIMS | Tanwar V.S.,SHKM Government Medical College | Sukhija G.,PGIMS | Mathur R.,PGIMS | Kaur P.,PGIMS
Indian Journal of Rheumatology | Year: 2017

Objective: To assess disease activity using Rheumatoid Arthritis Disease Activity Index-5 (RADAI-5) in patients with rheumatoid arthritis (RA) and its correlation with Disease Activity Score using 28 joint count (DAS28) and Clinical Disease Activity Index (CDAI). Methods: One hundred patients with active RA (as per ACR 1987 criteria) were assessed for disease activity using DAS28, CDAI, and RADAI-5. Spearman's correlation coefficient (ρ) and Cronbach's alpha were measured to assess the correlation between different disease activity scores and internal consistency, respectively. Results: In the study population, 81 patients were women and 19 patients were men. Mean age of the patients was 44.4 (±11.8) years. The median scores (interquartile range) for DAS28, CDAI, and RADAI-5 were 5.6 (2.0), 26.5 (22.0), and 5.8 (3.2), respectively. RADAI-5 was found to be significantly correlated with DAS28 and CDAI (allP < 0.001). Cronbach's alpha was highest for the RADAI-5. Conclusion: RADAI-5 had a positive correlation to DAS28 and CDAI for the assessment of disease activity, and it may be a good alternative to DAS28 and CDAI in busy outdoor settings. © 2017 Indian Journal of Rheumatology.


Chawla H.,Shkm Government Medical College | Malhotra R.,Shkm Government Medical College | Paliwal P.K.,Shkm Government Medical College
Journal of Indian Academy of Forensic Medicine | Year: 2016

Castration or Bobbitisation, as either a punishment or treatment for sex offenders, has been used throughout history and persists to the present day. After the brutal incident of gang rape in capital city of India that shocked the country, there was even demand of emasculation or castration as a punishment of rape. However, castration, that too in a case of railway accident is an unusual case of malice. Here, we are presenting an interesting and unusual case of animosity that was evaluated and later on confirmed, based on our observations. During post-mortem examination on a dead body of a male recovered from the railway track, multiple ante-mortem injuries involving vital areas like head and thorax were noted, but to our surprise, the victim's penis and scrotal sac were also missing, without corresponding tears on the garments. On careful evaluation, it was concluded that the injuries noticed all over the body were consistent with railway accident except that of amputation of penis along with scrotum. These amputation injuries were also ante-mortem and were caused by sharp edged weapon.


Sharma S.,Vardhman Mahavir Medical College and Safdarjung Hospital | Sharma S.C.,SHKM Government Medical College
Journal of Clinical Orthopaedics and Trauma | Year: 2016

Primary total hip replacement has become a routine procedure these days. With improvement in surgical techniques and implant designs, the survival rate of prosthesis has increased significantly but unfortunately, prosthetic infections though uncommon continue to be a threatening complication. We present a detailed review of the literature along with a case report of infected total hip prosthesis in a 36-year-old female who had been operated 6 years back. The causative organism was found to be Actinomyces israelii which was related to an infected intrauterine device used for contraception that had been forgotten after being implanted 8 years earlier. © 2015 Delhi Orthopedic Association.


PubMed | BP Koirala Institute of Health science and SHKM Government Medical College
Type: | Journal: Advances in medicine | Year: 2015

Aims. The aim of this study was to assess the self-perception of dental appearance among Eastern Nepalese patients using aesthetic component (AC) of the index of orthodontic treatment need (IOTN) and to compare it with that of an orthodontists assessment using the same scale and determine whether gender, area of residence, and level of education influence subjects self-perception and orthodontists ratings. Methods. A total of 252 subjects (equal number of male and female) were conveniently selected. The average ages of subjects were 22.33 2.114 years. The level of subjects perception and orthodontists assessment was analyzed by nonparametric Chi square test. Kappa coefficient was done to verify its agreement. The Spearmans correlation test was used to check the association of educational level and age. Mann-Whitney test was used to check the associations of sex and areas of residence. Results. The demand for treatment was significantly associated with the perception of the subject and orthodontists assessment. However, age, gender, and educational level were statistically insignificant in influencing subject perception and orthodontists assessment. Conclusion. Patients self-perception should be given equal importance while planning orthodontic treatment.


Aslam M.,Jamia Hamdard University | Maurya S.P.,SHKM Government Medical College
Journal of Forensic and Legal Medicine | Year: 2013

This is a case of attempted partial hanging that behaved like a cerebrovascular accident. The serial electrocardiograms (ECGs) showed the characteristic ST and T-wave changes, QT prolongation and U waves later reverting to normal over a period of one month. © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.


Verma R.,Pt. B.D. Sharma PGIMS | Khanna P.,Pt. B.D. Sharma PGIMS | Chawla S.,SHKM Government Medical College
Human Vaccines and Immunotherapeutics | Year: 2015

WHO defines adolescence age between 10 to 19 years. In India, there are 243 million adolescents which constitute 21 per cent of the total population. The global burden of disease in adolescents (2011) reports that the total number of disability adjusted life years (DALYs) worldwide among adolescents were 230 million which constitutes 15.5% of total DALYs. The immunization is one of the most important, most beneficial and cost-effective disease prevention measures that can be provided for adolescents. The adolescent vaccination protects most of the world’s adolescents from a number of infectious diseases that previously claimed millions of lives each year. In India, thousands of adolescents die and thousands are hospitalized every year due to communicable diseases that could have been prevented by vaccination. Main aims of adolescent vaccinations are: to boost immunity status that is waning after completion of primary immunization or absence of “natural” boosting due exposure to the particular disease. The recommendations for the immunization of adolescents are to improve vaccination coverage among them. The adolescent vaccinations also help in accelerate disease control or elimination effort. Improvement in adolescent immunization coverage in India, will require strengthening of health care delivery system and also require significant improvements in the health care functionaries ability and willingness to provide and deliver vaccines to adolescents. © 2015 Taylor & Francis Group, LLC.


Verma R.,Pt. B.D. Sharma PGIMS | Khanna P.,Pt. B.D. Sharma PGIMS | Chawla S.,SHKM Government Medical College
Human Vaccines and Immunotherapeutics | Year: 2015

India’s tourism industry generated 6.6% of the nation’s Gross Domestic Product (GDP) during 2012. International travel to India is predicted to grow at an average annual rate of ~8% over the next decade. The number of foreign tourists has increased by 9% to 5.8 million. Approximately 8% of travelers to developing countries require medical care during or after travel; the main diagnoses are vaccine-preventable diseases. Travelers to India can be exposed to various infectious diseases; water-borne, water-related, and zoonotic diseases may be imported to India where the disease is not endemic. The World Health Organization (WHO) emphasizes that all international travelers should be up to date with routine vaccinations. The recommended vaccinations for travelers to India vary according to the traveler’s age, immunization history, existing medical conditions, duration, legal requirements for entry into countries being visited, travelers preferences, and values. Travelers should consult with a doctor so that there is sufficient time for completion of optimal vaccination schedules. No matter where traveling, one should be aware of potential exposure to certain organisms that can cause severely illnesses, even death. There is no doubt that vaccines have reduced or virtually eliminated many diseases that killed or severely disabled children and adults just a few generations ago. Thus, travelers must take recommended vaccines per schedule before traveling to India. © 2015 Taylor & Francis Group, LLC.


Arora N.,SHKM Government Medical College | Sharma P.K.,University of Lucknow | Singh R.,University of Lucknow
Journal of the Anatomical Society of India | Year: 2013

Aim: The purpose of this study was to establish guidelines for normal splenic length at different ages by using a simple and reproducible sonographic method and to find out a relation between spleen length, age, height, weight, and surface area. Materials and methods: One hundred sixty subjects, from 21 years to 60 years old, had sonography because of abdominal and/or pelvic problems unrelated to the spleen. The splenic size was measured by obtaining a coronal view that included the hilum during deep inspiration to minimize masking by lung. The greatest longitudinal distance between the dome of the spleen and the tip (splenic length) was measured and correlated with age, height, and weight. Results: The results show that the splenic length decreased with increase in age in both males and females. The length of the spleen increased with increase in the body height, body weight, and body surface area in both males and females. In most of the subjects, the splenic length was found to be <11 cm. The splenic size in males was greater than that in females. Discussion: The findings of present study that the splenic length decreases with age are similar to the findings of Loftus and Metreweli. Konus et al in 1998 proposed that the splenic length correlated best with the body height. This is similar to the findings of the present study. The finding of present study that the splenic length has positive correlation with the body height, weight, and surface area is similar to the finding of Megremis et al. Conclusion: On the basis of the above study, it was concluded that the splenic length decreased with increase in age in both males and females. The length of the spleen has positive correlations with increase in the body height, body weight, and body surface area in both males and females. The splenic length was less in females than that in males with the corresponding age, body height, body weight, and body surface area. In most of the subjects, the splenic length was found to be <11 cm. © 2013, The Anatomical Society of India.


PubMed | Pt. B. D. Sharma PGIMS Rohtak and SHKM Government Medical College
Type: Journal Article | Journal: The Australasian medical journal | Year: 2015

Emergency departments rely on CT scans to manage trauma victims, especially for head injuries. Although the detection of an undisplaced fracture on a CT scan of the head without significant intracranial findings may be insignificant for a clinician, such cases are of paramount importance for medico-legal purposes because they help ascertain the nature, manner, and cause of the head injury.The study was conducted with the objective of knowing the sensitivity and specificity of ante-mortem CT scan findings indicating the presence or absence of skull fractures.Findings were confirmed during post-mortem examination of the subjects who had died during management but who had not had any surgical intervention. A comparative study of ante-mortem CT scan and autopsy findings with respect to fracture in traumatic head injuries was undertaken on 60 deceased individuals brought in for medico-legal post-mortem examination over a period of two years.Considering the autopsy findings as the gold standard, we have concluded that 14.6 per cent of the fractures were missed on CT scan findings compared to fractures found during autopsy. The sensitivity of CT scan for skull fractures was found to be 85.4 per cent and specificity was 100 per cent. Kappa was 0.787, which shows good agreement with p<0.001, which was highly significant.In developing countries, images are interpreted in the axial plane only on a CT scan of the head, which may be due to a lack of financial and human resources. For better delineation of fractures, the use of techniques like multi-detector CT with sagittal and coronal reformations should be considered in the routine interpretation of a CT scan of the head.


PubMed | Vardhman Mahavir Medical College & Safdarjung Hospital and SHKM Government Medical College
Type: Journal Article | Journal: Journal of clinical orthopaedics and trauma | Year: 2016

Primary total hip replacement has become a routine procedure these days. With improvement in surgical techniques and implant designs, the survival rate of prosthesis has increased significantly but unfortunately, prosthetic infections though uncommon continue to be a threatening complication. We present a detailed review of the literature along with a case report of infected total hip prosthesis in a 36-year-old female who had been operated 6 years back. The causative organism was found to be Actinomyces israelii which was related to an infected intrauterine device used for contraception that had been forgotten after being implanted 8 years earlier.

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