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Gautam A.,UCMS | Jalali G.K.,Shahid Beheshti University of Medical Sciences | Sahu K.K.,PGIMER | Deo P.,PGIMER
Journal of Clinical and Diagnostic Research | Year: 2017

Granulocytic Sarcomas (GS) also called as Myeloid Sarcomas (MS) or chloromas are the representatives of extramedullary infiltrates of immature myeloid cells including myeloblasts, promyelocytes and myelocytes. Primary cardiac malignancies per se are rare and infiltration of cardiac muscles by secondary malignant cells is also an uncommon finding. Out of these cardiac tumors, contribution of Cardiac Myeloid Sarcoma (CMS) is even more smaller thereby limiting our knowledge about this rare entity. Because of its very lower incidence, an exact guideline for diagnosis and management is still missing and usually haematologists around the world are treating CMS based on their clinical acumen. Aim of this review is to briefly discuss the presenting clinical feature, differential diagnosis, diagnostic workup and management based on published articles related to CMS till date. © 2017, Journal of Clinical and Diagnostic Research. All rights reserved.


Batra P.,UCMS
Current Rheumatology Reviews | Year: 2017

Systemic lupus erythematous (SLE) is a multisystem autoimmune disorder characterized by immune dysregulation and formation of autoantibodies. A high index of suspicion is necessary to diagnose SLE. Children have more systemic involvement than adults. Kidney involvement is seen in a significant proportion of child ren. With advancement of therapy the survival rate of patients with SLE has significantly improved. Even then lupus nephritis is still the most important predictor of morbidity and mortality. Treatment of lupus nephritis is mostly derived from studies in adults as data on children is still lacking. Prednisolone and cyclophosphamide was the mainstay of treatment till now. Recently drugs like mycophenolate mofetil, azathioprine, rituximab are also being used in treatment of lupus n ephritis with promising results and without significant adverse effects. In this review we will be discu ssing lupus nephritis, its diagnosis, pathogenesis, clinical picture and treatment advancements. © 2017 Bentham Science Publishers.


Kalra J.,Himalayan Institute of Medical science | Singh S.,UCMS | Badyal D.,Christian Medical College | Barua P.,Jorhat Medical College and HospitalAssam | And 3 more authors.
Indian Journal of Pharmacology | Year: 2016

Objectives: To explore poetry as a tool for active learning in linking knowledge and affective domains and to find if correlating learning with imagination can be used in 'assessment for learning.' Materials and Methods: After taking a conventional lecture on Asthma, a creative writing assignment in the form of poetry writing was given to the students. Different triggers were given to the students to channelize their thought pattern in a given direction that was linked to specific areas of academic relevance. Students were asked to reflect on this learning experience and the faculty was asked to evaluate the student assignment on a 5-point Likert scale. Results: Most student groups scored well in the 'overall assessment' of creative assignments and were rated as good or fair by the faculty. Students reflections were very informative and revealed that more than 90% of the students liked the exercise and many were too exuberant and liberal with emotional reactions that breathed positive. Around 5% students found the exercise average and another 5% found it very childish. Conclusion: Poetry writing turned out to be like a simulation exercise that linked academic knowledge, creativity, and the affective domain in an assumed scenario, rehearsed in free locales of mind. The metaphorical transition embedded in its subtle creation helped assess deeper understanding of the subject and the logical sequence of thought pattern. Key message: Poetry writing is like a simulation exercise that links academic knowledge, creativity and the affective domain in an assumed scenario, rehearsed in free locales of mind in the teaching of pharmacology. The richness of these student-generated creative projects indicates a need for reflective learning activities to be combined with subjective experiences, early in training. © 2016 Indian Journal of Pharmacology Published by Wolters Kluwer - Medknow.


PubMed | B P Koirala Institute Of Health Science and UCMS
Type: Journal Article | Journal: Indian journal of endocrinology and metabolism | Year: 2015

Diabetes ketoacidoisis (DKA) is characterized by hyperketonaemia, metabolic acidosis, and hyperglycemia.The aim of this study was to describe the demographic profile, clinical characterstics of patients admitted with diabetic ketoacidosis in BPKIHS, medical ward.The hospital based descriptive study.We took all the patients admitted with a diagnosis of diabetic ketoacidosis (DKA) as defined ADA 2006 consensus statement in medical ward from January 2010 to December 2010. The statistical operations was done through Manufactured by IBM Corp.Only sixteen patients (7 type 1 and 9 type 2DM) were with DKA. When compared to the 16 subjects with type 1 DM, the type 2 were older (56.8 s 25.7 years) and had a significantly higher PH levels (7.11 s 7.28 P = 0.04). The mean body mass index was 20.52.44 in both Type 1 and type 2 DM. Four were on diet control and Insulin respectively. Five were on oral hypoglycemic agents (OHA) and three on both (insulin and OHA). Infection was most common precipitating factor (56.25%) followed by poor drug compliance (37.5%) and first presentation (6.25%).We found majority of patients were type 2 DM. Metabolic acidosis has significant association in both type of diabetic. We found infection was the most common precipitating factor for DKA.


Chopra D.,Lady Hardinge Medical College | Bhandari B.,Jamia Hamdard University | Wardhan N.,UCMS
Current Clinical Pharmacology | Year: 2012

Ciclesonide (CIC) is a novel inhaled corticosteroid (ICS) approved by US Food and Drug Administration for the treatment of persistent asthma, available as a pressurized metered-dose inhaler in two strengths, 80 mcg/activation and 160 mcg/activation. Ciclesonide is a corticosteroid with unique pharmacological profile including a high degree of serum protein binding, a low oral bioavailability and rapid systemic elimination. Ciclesonide is a prodrug metabolized by esterases to desisobutyryl ciclesonide (des-CIC), an active metabolite with a 100-fold greater affinity for the glucocorticoid receptor. It has shown to improve pulmonary functions, reduce the need for oral corticosteroids (OCSs) and cause lesser suppression of the hypothalamic-pituitary-adrenal axis in asthmatic patients. Clinical efficacy studies suggest that Ciclesonide is superior to placebo and is at least as effective as several active comparators with an improved therapeutic margin thereby improving the therapeutic outcome in patients of asthma. © 2012 Bentham Science Publishers.


PubMed | UCMS, Jorhat Medical College and Hospital, Christian Medical College and Himalayan Institute of Medical science
Type: Journal Article | Journal: Indian journal of pharmacology | Year: 2016

To explore poetry as a tool for active learning in linking knowledge and affective domains and to find if correlating learning with imagination can be used in assessment for learning.After taking a conventional lecture on Asthma, a creative writing assignment in the form of poetry writing was given to the students. Different triggers were given to the students to channelize their thought pattern in a given direction that was linked to specific areas of academic relevance. Students were asked to reflect on this learning experience and the faculty was asked to evaluate the student assignment on a 5-point Likert scale.Most student groups scored well in the overall assessment of creative assignments and were rated as good or fair by the faculty. Students reflections were very informative and revealed that more than 90% of the students liked the exercise and many were too exuberant and liberal with emotional reactions that breathed positive. Around 5% students found the exercise average and another 5% found it very childish.Poetry writing turned out to be like a simulation exercise that linked academic knowledge, creativity, and the affective domain in an assumed scenario, rehearsed in free locales of mind. The metaphorical transition embedded in its subtle creation helped assess deeper understanding of the subject and the logical sequence of thought pattern.


Upadhyay M.,University of Delhi | Agarwal A.,UCMS | Agrawal P.,UCMS
Indian Journal of Public Health Research and Development | Year: 2015

Background: Adequate nutrition is critical to child health and development. The current status of feeding practices in India as cited by National Family Health Survey-3 (2005-2006) is rather dismal. Objectives: To study the prevalence of IYCF practices and its socio- demographic determinants among children under two years of age in Vivekvihar and Nandnagri To compare IYCF practices between the two study areas Materials and Method: A cross-sectional study was done in children between 0 – 23 months of age in September, 2010 using pretested semi-structured interview schedule in two colonies with different socioeconomic settings. Convenience sampling was done to include a total of 725 children in the study. Results: Breastfeeding was initiated within 1 hour of birth for 38% of newborns, 18.75% received pre-lacteal feeds while 93% received colostrum. 57% of infants had received exclusive breast feeding for 6 months. Practice of pre- lacteal feed was seen to be significantly more in infants of Nandnagri as compared to Vivekvihar (p value 0.029). However, infants of Vivekvihar were more likely to be exclusively breastfed as compared to Nandnagri (p value <0.001) and also more likely to receive Colostrum (p value <0.001). Conclusion: Overall the prevalence of IYCF practices were falling short of national goals set for the year 2007. Socio-demographic factors like place of residence, place of delivery, mother’s occupation do have a significant impact on IYCF practices. © 2015, Indian Journal of Public Health Research and Development. All rights reserved.


Ghosh S.K.,Rgkar Medical College | Rudra O.,Rgkar Medical College | Kar R.,UCMS | Ghosh A.,Rgkar Medical College | Agarwal M.,Rgkar Medical College
Dermatology Online Journal | Year: 2015

Introduction: Chromhidrosis is a rare sweat gland disorder characterized by the excretion of colored sweat. It can be classified as apocrine, true eccrine, and pseudochromhidrosis. Amongst the different types of chromhidrosis, green chromhidrosis is extremely rare. We describe herein a case of blue green chromhidrosis induced by ingestion of homeopathic medicine. Case report: A middle aged man presented to us with blue green discoloration of hands and feet. There was a preceding history of ingestion of homeopathic medication. Histopathology from the involved skin showed greenish particles within eccrine glands. Initial blood copper level was high which returned to normal level after discontinuation of the homeopathic medicine. Spectrophotometry revealed high copper content of the green sweat. Conclusion: Our case emphasizes the importance of considering any type of ingested medicine, including homeopathic medicine, as a probable cause of chromhidrosis. © 2015 by the article author(s).


Subedi S.,UCMS | Aich T.K.,BRD medical College | Sharma N.,UCMS
Journal of Clinical and Diagnostic Research | Year: 2016

Introduction: Electro-Convulsive Therapy (ECT) refers to the electrical stimulation of the brain to produce seizures for therapeutic purpose. Since the development of ECT, it’s use has been consistent. Inspite of the common use, data pertaining to the use of ECT in Nepal is lacking. Aim: This study was undertaken with the aim of exploring the clinico-demographic profile of patients treated with ECT in the largest psychiatry facility in the country. Materials and Methods: It is a retrospective descriptive study of patients who were treated with ECT after admission in the inpatient psychiatry unit of Universal College of Medical Sciences Teaching Hospital, Bhairahawa, Nepal during a period of one year (August 2012 to July 2013). Results: Out of 1095 patients admitted during the specified period, 81 (7.39%) patients received ECT. About 44.44% of the patients belonged to 20-29 years age group. Female patients constituted more than half of the subjects (55.56%). Review of diagnostic profile showed that majority of patients receiving ECT were suffering from Schizophrenia (44.4%), followed by Bipolar Affective Disorder/Mania (29.6%), Depressive disorder (11.1%), Acute and Transient Psychotic Disorder (6.2%), Post-partum Psychosis (3.7%) and substance induced mood/psychotic disorders (3.7%). A significant majority of subjects (75.3%) received about 5-7 ECT treatments. The mean seizure duration after ECT treatment was 31.13±5.79 seconds. No any major complications were noted during ECT treatment. Conclusion: This study suggests that ECT, use, as a treatment modality is common in young adults and females with Schizophrenia being the most common indication. Direct ECT is safe when used judiciously. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved.


Khan S.,UCMS | Rai P.,UCMS | Misra G.,UCMS
Journal of Clinical and Diagnostic Research | Year: 2015

Introduction: Prophylactic use of intra-peritoneal drain is commonly practiced by surgeons in the hope of early detection of complication and reducing mortality and morbidity. The aim of the study was to determine evidence based value of prophylactic drainage of peritoneal cavity in cases of secondary peritonitis and resection and anastomosis of small and large bowel. Materials and Methods: One hundred and seventy one (171) cases were included in the study from March 2012-May 2013 that underwent laparotomy for peptic ulcer perforation (PUP), simple and complicated acute appendicitis (appendicular perforation with localized/generalized peritonitis), small bowel obstruction (SBO) and sigmoid volvulus, traumatic and non-traumatic perforation of small and large bowel. Appropriate management was done after resuscitation and investigation. After completion of operation peritoneal cavity was either drained or not drained according operator’s preference. They were divided into drain and non-drain groups. Surgical outcome and postoperative complications ≤30 days of operation was noted and compared between two groups. Results: No significant difference was observed between drained group and non-drained group in terms of age (32.08±15.99 vs. 35.57 ± 16.42 years), Sex (76M: 42F vs. 40M: 13F), weight 50.9 ± 11.75 vs. 48.4 ± 16.1 kg), height (1.6 ± 0.13 vs. 1.5 ± 0.18 Meter), BMI (20 ± 4.7 vs. 20 ± 7.2), ASA score (p= >0.05). However there was significant difference was observed between drained group and non-drained groups in terms of length of hospital stay (9 ± 4 vs 5 ± 3.4 days), operative duration (115.6 ± 41.0 vs. 80 ± 38.1 minutes), infection rates in dirty wound (40.0% vs 12.5%) and overall postoperative complications (35.85% vs16.11%). Conclusion: Based on these results, present study suggests that prophylactic drainage of peritoneal cavity after gastrointestinal surgery is not necessary as it does not offer additional benefits for the patients undergoing gut surgery. Moreover, it increases operative duration, length of hospital stay and surgical site infection (SSI). © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.

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