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PubMed | SMS Medical College Jaipur and Manipal Teaching Hospital
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2014

In Bipolar disorder the mood of the patients fluctuates between depression and mania. The main objective of the study was to find out the commonest mood stabilizers used for the treatment of Bipolar affective disorders in Western Nepal in hospitalized patients in an actual clinical set up.This was a cross-sectional study which was conducted between October 2009 and September 2010 at Psychiatric ward at Manipal teaching hospital, Pokhara, Nepal, a tertiary care hospital situated in Western Nepal. The diagnosis of the disease was based on ICD-10 (Tenth revision) Classification of mental and Behavioural disorders, Diagnostic Criteria for Research. We calculated odds ratio and their 95% confidence intervals (95% CI). p< 0.05 was considered as statistically significant.62.1% of the patients were less than 40 yrs, 56.3% were male, 72.4% were unemployed and 75.9% of the patients were having monthly income <10,000/month. As far as ethnicity is concerned 37.9% of the cases were Brahmin and by occupation 29.9% of the patients were students followed by housewife 25.3%, labour 17.2%, retired 13.8% respectively. Drugs and Psychotherapy [OR 1.4, 95% (CI 0.575, 3.4017)] was prescribed in age <40 years as compared to age>40 yrs. Male patients [OR 7.22, 95% (CI 0.862, 60.499)] and [OR 2.353, 95% (CI 0.857, 6.455)] received drugs by trade names and drugs not from the national drug list of Nepal as compared to females. Monthly income <10,000/month and [OR 2.8, 95% (CI 0.742, 10.56)] tendency of receiving drugs by trade names. Among the mood elevators Sodium valproate was the commonest drug to be prescribed in 51/87(58.6%) patients followed by Lithium in 30/87 (34.5%) cases and Carbamazepine in 6/87 (6.9%) cases. Sodium valproate was prescribed at 1,000 mg/day, Lithium was prescribed at 900 mg/day in and Carbamazepine was prescribed at 800 mg/day.Among all the mood elevators Sodium valproate is the commonest drug prescribed for the treatment of bipolar affective disorder, recommended that there is a trend of using newer drugs like sodium valproate rather than the conventional mood stabilizers like Lithium for bipolar affective disorder in Western Development region of Nepal.

Yadav A.,NIMS Medical College | Pathak D.,SMS Medical College Jaipur | Alam F.,SMS Medical College Jaipur | Vyas N.,SMS Medical College Jaipur
Medico-Legal Update | Year: 2014

Forensic medical personnel are at risk of exposure to blood-borne viruses including HIV, Hepatitis B and Hepatitis C virus. The aim of this study was to determine seropositivity of HIV, HBV and HCV among a cadaver population at the SMS hospital, Jaipur. The study group consists of Four hundred eighteen randomly picked subjects over a period of one year from October 2008 to September 2009. These cadavers were screened for HIV antibodies, HBs Antigen (hepatitis B surface antigen) and HCV antibodies (hepatitis C virus antibodies) by applying ELISA Test. For HIV antibodies initial reactive tests were confirmed by Tridot Test and SD Bioline test as per NACO guideline. The maximum numbers of deceased in the present study group were in the age range of 15-44 years being 295 in number (70.58%). Out of these, 224 (75.9%) were males and 71 (24.06%) were females. In all 46 (11.0%) samples out of 418 were seropositive for HIV, HBV and HCV infections. From 418 subjects, 10 were seropositive for HIV (2.39%).all of them males. Seropositivity for HCV was found in 7(1.67%); males only. Out of 29 subjects seropositive for HBV, majority i.e. 17 (58.62%) were in age range of 15-44 years. In the serological status of HBV, 29(6.94%) subjects showed positive results. Among them 21 were males and 8 were females. All forensic cadavers should be treated as potentially infectious and universal precautions should be taken.

Nagaich N.,SMS Medical College Jaipur | Nijhawan S.,SMS Medical College Jaipur | Katiyar P.,SMS Medical College Jaipur | Sharma R.,SMS Medical College Jaipur | Rathore M.,SMS Medical College Jaipur
Diseases of the Esophagus | Year: 2014

Increasingly frequent dilation may become a self-defeating cycle in refractory stricture as recurrent trauma enhance, scar formation, and ultimately recurrence and potential worsening of the stricture. In 12 patients of caustic induced esophageal stricture, who failed to respond despite rigorous dilatation regimen for more than one year, a trial of topical mitomycin-C application to improve dilatation results was undertaken, considering the recently reported efficacy and safety of this agent. Mitomycin-C was applied for 2-3 minutes at the strictured esophageal segment after dilation with wire-guided Savary-Gilliard dilator. Patient was kept nil by mouth for 2-3 hours. After 4-6 sessions of mitomycin-C treatment, resolution of symptoms and significant improvement in dysphagia score and periodic dilatation index was seen in all 12 patients. Mitomycin-C topical application may be a useful strategy in refractory corrosive esophageal strictures and salvage patients from surgery. © 2013 Wiley Periodicals, Inc. and the International Society for Diseases of the Esophagus.

Chauhan M.,SMS Medical College Jaipur | Garg A.,SMS Medical College Jaipur | Bharadwaj A.,SMS Medical College Jaipur
Paediatric Anaesthesia | Year: 2013

Background Use of propofol in pediatric age group has been marred by reports of its adverse effects like hypertriglyceridemia and acute pancreatitis, although a causal relation has not yet been established. Objectives This prospective, clinical trial was carried out to evaluate the effects of short-term propofol administration on serum lipid profile and serum pancreatic enzymes in children of ASA physical status I and II aged between 1 month and 36 months. Methods Anesthesia was induced with Propofol (1%) in the dose of 3 mg·kg-1 intravenously and was maintained by propofol infusion (0.5%) at the rate of 12 mg·kg-1·h-1 for the first 20 min and at 8 mg·kg-1·h-1 thereafter. The mean dose of propofol administered was 12.02 ± 2.75 mg·kg-1 (fat load of 120.2 ± 27.5 mg·kg -1). Lipid profile, serum amylase, and lipase were measured before induction of anesthesia, at 90 min, 4 h, and finally 24 h after induction. Results Serum lipase levels (P < 0.05), serum triglyceride levels (P < 0.05), and serum very low-density lipoproteins VLDL levels (P < 0.05) were raised significantly after propofol administration from baseline although remained within normal limits. Serum cholesterol levels and serum low-density lipoproteins LDL levels showed a statistically significant fall over 24 h. No significant changes in serum pancreatic amylase levels were seen (P > 0.05). None of the patients developed any clinical features of pancreatitis in the postoperative period. Conclusion We conclude that despite a small, transient increase in serum triglycerides and pancreatic enzymes, short-term propofol administration in recommended dosages in children of ASA status I and II aged between 1 month and 36 months does not produce any clinically significant effect on serum lipids and pancreatic enzymes. © 2012 Blackwell Publishing Ltd.

PubMed | SMS Medical College Jaipur
Type: Journal Article | Journal: APSP journal of case reports | Year: 2016

Post-electric burn ileal perforation is a rare but severe complication leading to high morbidity and mortality if there is delay in diagnosis and management. We are describing a case of electric current injury of left forearm, chest, and abdominal wall with perforation of ileum in an 8-year old boy. Patient was successfully managed by primary closure of the ileal perforation.

PubMed | Sms Medical College Jaipur
Type: Journal Article | Journal: Indian journal of psychiatry | Year: 2011

Goldbergs GHQ was translated into Hindi. An emphasis was made to have the language of common use. The reliability of GHQ Hindi version (GHQ-H) was tested by translation - retranslation method and split-half method using the scores of 500 patients attending psychiatric out-patient department and 500 normal subjects. The tool was found to be sensitive and reliable. The tool differentiates normal population (mean score 4.9) from the patient population (mean score 30.64) statistically (p < 0.01) indicating a high validity. Details of methodology are described and its subsequent use is advocated.

PubMed | SMS Medical College Jaipur
Type: Journal Article | Journal: APSP journal of case reports | Year: 2016

The foreign body ingestion is a rare cause of gastrointestinal perforation in children and is typically seen with sharp foreign bodies or button batteries. Herein, we report an 11-month old male baby who presented with obstructed umbilical hernia. Abdominal radiograph showed dilated small bowel loops, while ultrasonography and CT scan suggested presence of a foreign body. Laparotomy revealed obstructed umbilical hernia with a plum seed being stuck in the terminal ileum causing intestinal perforation. Resection and anastomosis of intestine was performed.

PubMed | SMS Medical College Jaipur
Type: Case Reports | Journal: Scandinavian journal of infectious diseases | Year: 2014

Herpes zoster is reactivation of the varicella zoster virus that has remained dormant in the dorsal root ganglia since an earlier episode of chickenpox. Herpes zoster has variable clinical presentations, but meningo-encephalitis is not frequently encountered. There is growing evidence of both large and small vessel involvement in immunocompetent and immunocompromised patients, in contrast with the previous opinion that immunocompetent patients have vasculopathy in the large vessels while immunosuppressed patients have vasculopathy in the small vessels. We present the case of a patient in whom herpes zoster meningoencephalitis was complicated with multifocal vasculopathy with peripheral vascular disease; this is an unusual co-occurrence.

PubMed | SMS Medical College Jaipur
Type: Journal Article | Journal: APSP journal of case reports | Year: 2016

Paediatric age group is most vulnerable for the accidental foreign body (FB) ingestion which may go unnoticed. These patients present with symptoms or complications as a result of FB and may mimic other conditions on various investigations. We describe a 9-month old infant who ingested crystal gel ball and presented with vomiting for a month. On radiological imaging it was interpreted as duplication cyst of the duodenum. At operation, crystal gel ball was retrieved. Our case vindicates importance of keeping various possibilities in mind as differential diagnoses during evaluation and management of surgical ailments such as the duplication cyst of duodenum.

PubMed | SMS Medical College Jaipur
Type: Journal Article | Journal: Journal of neonatal surgery | Year: 2016

Duodenal atresia is a frequent cause of intestinal obstruction in the newborn. Obstruction due to duodenal web is infrequent, but its location other than second part of duodenum is rare with only a few cases reported in the literature. We are reporting three patients where we found duodenal webs at unusual locations. In one neonate the web was located at third part of duodenum and in other two patients the web was present at duodeno-jejunal junction (DJ).

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