Swami Rama Himalayan University

Dehradun, India

Swami Rama Himalayan University

Dehradun, India
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Raj A.,Swami Rama Himalayan University | Dhasmana R.,Swami Rama Himalayan University | Bahadur H.,Swami Rama Himalayan University
Journal of Current Ophthalmology | Year: 2017

Purpose: The aim of the study was to evaluate the various donor and recipient factors associated with short-term prevalence of surface epithelial keratopathy after optical penetrating keratoplasty (OPK). Methods: Preoperative and postoperative data of 91 eyes of 91 patients were reviewed retrospectively who had undergone OPK from March 2013 to February 2016. Donor and recipient data were analyzed for age and sex of the donor, cause of death, death to enucleation time (DET), death to preservation time (DPT), enucleation to utilisation time (EUT) and total time (TT), age and sex of recipient, indications of penetrating keratoplasty (PK), associated glaucoma and recipient size (RS). The presence of various epitheliopathies were recorded at various postoperative visits. Results: The range of age of recipient in this study was 10-83 yrs (mean 49.19 ± 19.35 yrs). The donor age ranged in between 17 and 95 years (70.27 ± 15.11 years). Age and preoperative diagnosis of host showed significant influence on epitheliopathy till two weeks and one month post-PK (P = 0.032 and 0.05), respectively. Donor's age and gender showed significant impact on surface keratopathy till two weeks follow-up with P value of 0.04 and 0.004, respectively. DET, DPT, EUT, and TT affected the surface epithelium significantly with P value of 0.007, 0.001, 0.05, and 0.03, respectively. On first postoperative day 33 (36.26%) eyes developed epithelial defect involving >1/2 of cornea. Conclusion: Various donor and recipient factors showed influence on various epithelial abnormalities of surface epithelium in early postoperative period. © 2017 Iranian Society of Ophthalmology.

Malhotra Y.,Swami Rama Himalayan University | Kaushik R.M.,Swami Rama Himalayan University | Kaushik R.,Swami Rama Himalayan University
Endocrine Research | Year: 2017

Purpose: To study the prevalence of left ventricular diastolic dysfunction (LVDD) in patients with subclinical hypothyroidism (SCH) and the response of LVDD to L-thyroxine therapy. Materials and methods: This cross-sectional case–control study with one longitudinal arm included 67 patients with SCH attending a tertiary care hospital in Uttarakhand, India, and 67 age- and sex-matched healthy controls. LVDD was assessed by 2D, pulsed-wave Doppler (PWD), continuous wave Doppler (CWD), and tissue Doppler echocardiography (TDE). Patients with LVDD received L-thyroxine therapy with reassessment for LVDD 6 months later. Results: SCH patients had a higher prevalence of LVDD than controls (13.43% versus 1.49%; p = 0.017). LVDD showed a significant association with gender (p = 0.004) and serum FT4 (p = 0.001). E velocity, E’ velocity, A’ velocity, iso-volumetric relaxation time (IVRT), E/A, and E’/A’ ratios were significantly lower, while A velocity, deceleration time (DT), E/E’ ratio, left atrial (LA) volume index, and peak tricuspid regurgitation (TR) velocity were significantly higher in cases than controls (p < 0.05 each). The E/A ratio correlated significantly with age, serum very low-density lipoprotein (VLDL), triglycerides (TG), thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and high-density lipoprotein (HDL) (p < 0.05 each). E’ velocity correlated significantly with age, serum total cholesterol, VLDL, and TG (p < 0.05 each), DT with serum total cholesterol (p = 0.047), and LA volume index with age (p = 0.021). Age (p = 0.016) and serum HDL (p = 0.029) were independent predictors of E/A ratio. Gender was an independent predictor for LVDD (p = 0.003). Echocardiographic indices for LVDD showed significant improvement after 6 months of L-thyroxine therapy (p < 0.05 each). Conclusions: LVDD occurs commonly in SCH patients. It can be detected timely using echocardiography and may be reversed by L-thyroxine therapy. © 2017 Taylor & Francis

Gupta N.,Swami Rama Himalayan University | Upadhyay P.,Swami Rama Himalayan University
Indian Journal of Ophthalmology | Year: 2017

Purpose: This study was carried out to see the results of glycerol-preserved cornea (GPC) in emergency situation when fresh corneal tissue was not available. The aim was to study the outcome of corneal transplantation using GPC. Methods: This was a retrospective study. The medical records of all the patients were reviewed, who underwent keratoplasty using 'GPC' during the period from October 2011 to December 2015. The indication of keratoplasty, duration of preservation of the GPC, and its outcome were analyzed. Descriptive statistics were applied. Results: Out of the 222 penetrating keratoplasty (PKP) performed over the study period, the GPC was used in 34 patients (males = 31, 91.2%) aged 15-74 years. Therapeutic keratoplasty was performed in all cases in this cohort except one in which tectonic keratoplasty was done. The primary indication of PKP (91.2%) was infectious keratitis. Of these, 20 (64.5%) patients presented with perforated corneal ulcers. Post-PKP, ocular anatomy was preserved in 91.2%, and visual acuity of perception of light positive and accurate projection of rays in all the quadrants was obtained in 76.5% cases. Complications included glaucoma (n = 12, 35.1%), phthisis bulbi (n = 2, 5.9%), and graft reinfection and endophthalmitis after PKP (n = 1, 2.9%). The secondary procedure post-GPC and PKP were trabeculectomy with mitomycin C (n = 7, 58.3%) in patients not controlled on topical antiglaucoma medication. Optical keratoplasty was performed in (n = 3) 8.8% patients and triple procedure in (n = 2) 5.8% patients with good visual acuity postprocedure. Conclusions: Acellular GPCs are useful in emergency keratoplasty to avoid loss of vision and can save the eye. © 2017 Indian Journal of Ophthalmology.

Joshi B.,Jaypee Institute of Information Technology | Joshi B.,Swami Rama Himalayan University | Rani K.,Jaypee Institute of Information Technology
Advances in Intelligent Systems and Computing | Year: 2017

Cloud Computing refers to rendering services to the users over the internet. It includes the hardware and software in the datacenter which facilitates these services. This concept was introduced to increase the utilization of the resources available and to decrease the cost to the user because of the sharing nature of the resources. It offers a number of benefits but with those benefits come a large number of challenges. These challenges need to be tackled by the service provider in order to provide secure and reliable service. Data Storage being the main area of concern as the private data of all the users are stored at one place at all times. This data must be kept available only for that user to whom it belongs and an additional level of security must be introduces in order to prevent breach into these private sections. This paper tries to address these issues and strategies to mitigate them. © Springer Nature Singapore Pte Ltd. 2017.

Dalal L.K.,Swami Rama Himalayan University | Dhasmana R.,Swami Rama Himalayan University | Maitreya A.,Swami Rama Himalayan University
Annals of African Medicine | Year: 2017

Purpose: To study the anterior segment (AS) parameters using AS optical coherence tomography (AS-OCT) in the North Indian population. Methods: A hospital-based, observational, cross-sectional study was conducted over a period of 1 year. It included 251 normal individuals aged 20-70 years. Participants underwent imaging with AS-OCT.Ocular parameters included anterior chamber angle (ACA), iris cross-sectional area (ICSA), iris thickness (IT), and iris curvature (IC). The parameters were measured nasally and temporally for both sexes and different age groups. Results: The mean age of participants was 48.3 ± 13.9 years and 50.6% were men. The ACA decreased with age whereas ICSA, IT, and IC increased with age. The ACA (P = 0.0001nasally and temporally), ICSA (P = 0.011 nasally, P = 0.027 temporally), IT750 (P = 0.001 nasally, P = 0.011 temporally), IT1500 (P = 0.002 nasally, P = 0.002 temporally), and IC (P = 0.059 nasally, P = 0.128 temporally) underwent statistically significant changes with increasing age. No significant difference was seen in parameters of different sex. Conclusion: In this subset of the Indian population, the change in the AC parameters with age influences the AC dimensions predisposing the eye to glaucomatous conditions. These data are applicable clinically for the assessment and surgical management of patients requiring AS surgery. © 2017 Annals of African Medicine / Published by Wolters Kluwer - Medknow.

Rana G.,Swami Rama Himalayan University | Goel A.K.,CSIR - Central Electrochemical Research Institute
International Journal of Knowledge Management Studies | Year: 2017

Effective knowledge management (KM) helps an organisation control and institutionalise its knowledge-based processes and create an organisational culture that fosters and encourages continuous learning resulting in a skilled and knowledgeable workforce. This paper seeks to observe the KM practices prevalent in Bharat Heavy Electricals Ltd, a Maharatna PSE of the Government of India, and includes a case study on the organisation. The KM practices followed by the company have been assessed with the help of a KM performance scorecard (e-map scorecard). The study further examines the in-house knowledge sharing processes and the extent to which information and technology is used to facilitate the exchange of knowledge. Findings reveal that linking KM practices with organisational goals increased the likelihood of the achievement of those goals. Copyright © 2017 Inderscience Enterprises Ltd.

PubMed | Swami Rama Himalayan University and Max Superspeciality Hospital
Type: | Journal: The neuroradiology journal | Year: 2017

A young adult female with restricted water intake during the postpartum period presented with history of progressive weakness, dizziness and tendency to fall with generalized slowing of movement. On examination, patient was anaemic, febrile and stuporous. Investigations revealed hypernatremia, delta waves in electroencephalogram (EEG) and features suggestive of extra-pontine myelinolysis on magnetic resonance imaging (MRI) of brain. After correcting hypernatremia and instituting anti-cholinergic therapy, there was a gradual but steady improvement in neurological symptoms of the patient over a period of one week and the patient was discharged in a conscious, oriented and ambulant state. As such, neuroimaging findings can be crucial in diagnosing hypernatremic encephalopathy in the postpartum period.

Jain A.,Swami Rama Himalayan University | Kaushik R.,Swami Rama Himalayan University | Kaushik R.M.,Swami Rama Himalayan University
Acta Tropica | Year: 2016

This prospective study assessed the incidence, clinical profile and outcome of malarial hepatopathy and its association with other complications in patients with malaria, proved by peripheral blood smear examination and rapid malaria test. Hyperbilirubinemia (Serum bilirubin >3 mg/dL) with >3-fold rise in serum aminotransferases in absence of a different explanation for such derangement was considered as malarial hepatopathy. Of 134 (falciparum-81, vivax-48 and mixed falciparum and vivax-5) malaria cases, hyperbilirubinemia occurred in 41.04%. Serum aspartate aminotransferase (AST) was raised >3-fold in 17.16% and serum alanine aminotransferase (ALT) in 4.47% cases. Malarial hepatopathy was observed in 4.47% (falciparum-5 and vivax malaria-1) cases, but had insignificant association with the type of malaria (p = 0.532). Serum bilirubin, AST and ALT levels were higher while age was lower overall (p < 0.05 each) and in falciparum malaria cases with hepatopathy than without hepatopathy (p < 0.05 each). Malarial hepatopathy was associated with a higher incidence of cerebral malaria, shock, hyponatremia, acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation overall (p < 0.05 each) and in falciparum malaria (p < 0.05 each) and acute kidney injury only in overall malaria (p < 0.05). Malarial hepatopathy had significant association with duration of hospitalization, parasite clearance time, fever clearance time and jaundice clearance time overall (p < 0.05 each) and in falciparum (p < 0.05 each) but not vivax malaria (p > 0.05 each). Mortality occurred in 1 (20%) case of falciparum-induced hepatopathy with an overall mortality of 16.66%. ARDS (p = 0.003) and shock (p = 0.026) were independently associated with malarial hepatopathy overall while only ARDS with falciparum-induced hepatopathy. Thus, hepatocellular dysfunction is common in malaria but that qualifying as malarial hepatopathy is not common. Malarial hepatopathy is likely to occur in presence of other malarial complications. It is an epiphenomenon in severe malaria and indicative of severe disease. Establishing a particular association with malaria or mortality would require a larger case-control study of severe malaria. © 2016 Elsevier B.V.

Ahmad S.,Swami Rama Himalayan University | Mittal M.,Swami Rama Himalayan University
Journal International Medical Sciences Academy | Year: 2015

Diabetic peripheral neuropathy is a well-known microvascular complication of type 2 diabetes mellitus attributed to chronic hyperglycemia. Tingling paraethesias, pain and hyperesthesias in the feet occur in newly diagnosed or poorly Table controlled 1: Severity diabetics of Diabetic and the Polyneuropathy symptoms resolve with proper glycemic control. The present article focuses on classification of diabetic neuropathy and its management. © 2015, International Medical Sciences Academy. All rights reserved.

PubMed | Swami Rama Himalayan University and All India Institute of Medical Sciences
Type: Journal Article | Journal: Mediterranean journal of hematology and infectious diseases | Year: 2017

Classically associated with We retrospectively compared patients with malaria hospitalised from 2009-15, with (n=105) and without (n=1155) neurological involvement regarding outcomes, complications, demographic attributes, clinical features, and laboratory parameters. Subsequently, the same parameters were studied in those with cerebral malaria due to mono-infections of Cerebral malaria was observed in 8.3% (58/696), 7.4% (38/513) and 17.6% (6/51) of The plasmodial species are comparable in clinical and laboratory parameters and outcomes in cerebral malaria in isolation and combination (p>0.05).

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