Dilshad Garden, India
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Mathew J.L.,PGIMER | Aggarwal A.,UCMS & GTB Hospital | Balasubramanian S.,Child Trust Hospital
Indian Pediatrics | Year: 2015

In this phase-3 efficacy trial of a tetravalent dengue vaccine in five Latin American countries, 20,869 healthy children between the ages of 9 and 16 years were randomly assigned in a 2:1 ratio to receive three injections of recombinant, live attenuated, tetravalent dengue vaccine (CYD-TDV) or placebo at months 0, 6, and 12 under blinded conditions, and followed for 25 months. The primary outcome was vaccine efficacy against symptomatic, virologically-confirmed dengue occurring more than 28 days after the third injection. At baseline, 79.4% of an immunogenicity subgroup of 1944 children had seropositive status for one or more dengue serotypes. In the per-protocol population, there were 176 dengue cases (with 11,793 person-years at risk) in the vaccine group and 221 dengue cases (with 5,809 person-years at risk) in the control group, for a vaccine efficacy of 60.8% (95% CI 52.0%, 68.0%). Serotype-specific vaccine efficacy was 50.3% for serotype 1, 42.3% for serotype 2, 74.0% for serotype 3 and 77.7% for serotype 4. Among the severe confirmed dengue cases, 1 of 12 was in the vaccine group, for an intention-to-treat vaccine efficacy of 95.5%. Vaccine efficacy against hospitalization for dengue was 80.3%. The authors concluded that CYD-TDV dengue vaccine was efficacious against virologically-confirmed dengue infection, including severe disease. © 2015, Indian Academy of Pediatrics.


PubMed | UCMS & GTB Hospital, Institute of Cytology & Preventive Oncology and Institute of Genomics and Integrated Biology
Type: Journal Article | Journal: Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine | Year: 2016

This study aimed to investigate the role of miRNAs in HPV-mediated cervical pre-cancer and cancer cases in Indian population. We analysed the HPV infection and its genotypes in uterine cervical pre-cancer (n=80), cancer (n=200) and normal cervical samples (n=150) by consensus sequence PCR followed by type specific PCRs. Also, microRNA profiling was done in a subset of cervical pre-cancer (n=20), cancer cases (n=50) and normal samples (n=30) by real-time quantitative PCR (qRT-PCR). The prevalence of HPV infection in pre-cancer was found to be 81% (65/80) and 94% (188/200) in cancer cases, with most predominant high-risk HPV type-16 (HR-HPV-16) in 83% of cancer and 91% of pre- cancer cases, respectively. Whereas in controls, the HPV infection was found to be very low (5%). The miRNA profiling revealed that in cervical pre-cancer, 100 miRNAs were significantly (p<0.001) differentially expressed with 70 miRNAs upregulated and 30 miRNAs downregulated. In cervical cancer cases, 383 miRNA were found to be differentially expressed (p<0.001), of which 350 miRNAs were upregulated and 33 miRNAs were downregulated. We also observed that 182 miRNAs were differentially expressed (p<0.001) in HPV-16/18-positive (SiHa/HeLa) cell lines compared with HPV-negative (C33A) cell line. In addition, we identified the novel microRNAs such as miR-892b, miR-500, miR-888, miR-505 and miR-711 in cervical precancerous lesions and cervical cancer cases in Indian population. Taken together, the study demonstrates a crucial role of microRNAs in cervical cancer, which may serve as potential early diagnostic markers for cervical carcinogenesis.


PubMed | UCMS & GTB Hospital and CSIR - Central Electrochemical Research Institute
Type: Journal Article | Journal: FEMS microbiology letters | Year: 2015

Trichophyton rubrum is one of the major causative agents of dermatophytosis in humans worldwide. We report the draft genome sequence of T. rubrum var. raubitschekii from Delhi, India, isolated from a patient presenting symptoms of onychomycosis. The total estimated genome size of the clinical isolate is 25.2 MB containing 8265 predicted protein-coding sequences, 91 tRNA and 15 rRNA genes. Sequence analysis of the secreted subtilases, one of the major virulence factors in dermatophytes, clusters them into three subfamilies with distinct sequence features. The genome sequence is a step in understanding diversity of dermatophytes worldwide and will aid in identification of virulence factors and dissecting mechanisms of pathogenesis among them.


Kumar S.,UCMS & GTB Hospital | Joshi M.K.,University of Delhi
Indian Journal of Surgery | Year: 2015

The anatomical description of the area requiring dissection during cholecystectomy is incomplete and incorrect. We carefully observed the anatomy of this region for over 20 years in various biliary pathologies and present our view. Describing this area in the form of triangles is incorrect. There exists a definite plane between the two folds of peritoneum in this region, wherein the cystic duct and the cystic artery traverse. The description of the “triangles” that require dissection during cholecystectomy are not strictly geometrical triangles; hence, the area bounded by these so-called triangles should be renamed as “Calot’s region.” The surgeons should take advantage of the existence of a definite “ducto-arterial plane” in the Calot’s region and dissect it sharply to avoid ductal and vascular injuries. © 2014, Association of Surgeons of India.


Tandon A.,UCMS & GTB Hospital
BMJ case reports | Year: 2011

We present a case of a 5-year-old child with a painless swelling on the neck. Imaging revealed a multilocular cystic lesion lying in close proximity to carotid vessels. Based on imaging a possibility of ectopic thymic cyst was considered, which was confirmed on histopathology. Ectopic cervical cyst is an infrequent cause of neck cyst in a child which is rarely diagnosed preoperatively.


Gulati D.,UCMS GTB Hospital | Agarwal A.,CNBC
Ulusal Travma ve Acil Cerrahi Dergisi | Year: 2010

We report herein a case in which symptoms appeared eight years after the apparent trauma, which had been forgotten. Surgery yielded a wooden foreign body in the forearm. A 10-year-old boy presented with a six-week history of pain followed by swelling in his left forearm occurring after a trivial blunt trauma, with occasional bouts of fever. There was an oval swelling (7 cm × 3 cm) on the posterolateral aspect of the upper third of the left forearm. Tenderness, increased local temperature and elicitable fluctuation, with no scars or wounds (signs of trauma), were noted. Radiographs of the forearm revealed a soft tissue swelling but no fracture, periosteal reaction or other bony lesion. Aspiration of the swelling yielded purulent material (gram stain negative). The abscess was drained and exploration of the cavity revealed a 14 mm long slender wooden foreign body embedded in granulation tissue. On retrospective enquiry, the family reported that the child had sustained a penetrative injury eight years before after falling on a broomstick. Presence of a foreign body must be kept in mind while investigating a suspicious swelling on the extremities. A thorough history and careful imaging are the keys to diagnosis.


Khan A.M.,UCMS & GTB Hospital
Indian journal of public health | Year: 2012

A cross sectional study was conducted to study the diet pattern of children less than 2 years with regard to certain infant and young child feeding (IYCF) indicators. A total of 374 children less than 24 months of age coming to the immunization clinic were studied using a standard pretested and prevalidated questionnaire. Exclusive breastfeeding was followed by 57.1% of children under 6 months of age. Minimum dietary diversity, minimum meal frequency, and minimum acceptable diet were seen adequate in 32.6%, 48.6%, and 19.7% of children between 6 months and 2 years of age, respectively.


PubMed | UCMS & GTB Hospital
Type: Journal Article | Journal: The international journal of occupational and environmental medicine | Year: 2016

Occupational exposure to excessive level of copper results in many adverse health effects.To measure pulmonary function, oxidative stress, and extent of DNA damage in workers of a copper processing industry.30 men working in a copper processing industry and 30 men matched for age and socioeconomic status (comparison group) were included in this study. Pulmonary function test parameters were measured for all participants. Serum malondialdehyde (MDA), ferric reducing ability of plasma (FRAP), glutathione (GSH) content in RBCs and 8-OHdG were assayed by ELISA. Extent of DNA damage in leucocytes was assayed by comet assay.Pulmonary function parameters, FVC, FEV1, PEFR, and MVV measured in workers were significantly (p<0.05) lower than those observed in the comparison group. Compared to the comparison group, MDA was significantly (p=0.002) increased in studied workers; TAOC (p=0.017), and GSH (p=0.020) were significantly lower in workers than the comparison group. There was significant DNA damage in leucocytes in workers compared to the comparison group (difference in olive tail moment p<0.001). PEFR, FEF25-75%, and MEF50% were negatively correlated with MDA.The observed DNA damage would be due to increased oxidative stress resulting from excessive exposure to copper.


PubMed | UCMS & GTB Hospital
Type: | Journal: European journal of obstetrics, gynecology, and reproductive biology | Year: 2016

To compare the efficacy and acceptability of combined hormonal vaginal ring with combined oral hormonal pill in women with idiopathic chronic pelvic pain.Randomised prospective interventional trial conducted in 60 women with idiopathic chronic pelvic pain. Women were randomised into two groups of 30 each. In each group, treatment was given for 84days using either combined vaginal ring or combined oral hormonal pill. Hormonal vaginal ring releases 15mcg of ethinyl estradiol and 120mcg of the etonogestrel per day while the hormonal pill contained 30mcg of ethinyl estradiol and 150mcg of levonorgestrel. There was no ring or pill free week. After every 28 days, pain relief was measured using visual analogue scale (VAS), and verbal rating score (VRS) calculated by summing dysmenorrhea, non-cyclic pelvic pain (NCCP) and deep dyspareunia scores. Side effects, compliance, satisfaction, and user acceptability were also measured. Data was analyzed using various parametric and non-parametric tests.Reduction in mean VAS score at end of treatment in ring group was 6.23 (95% confidence interval [CI], 5.45-7.01; p<0.001) as compared to 5.53 in pill group (95% CI, 4.83-6.23; p<0.001). Reduction in mean VRS score was 5.63 in ring users (95% CI, 4.84-6.42; p<0.001) versus 4.36 in pill users (95% CI, 3.63-5.10; p<0.001). A significantly higher persistent relief in NCPP score was observed in vaginal ring group as compared to oral pill group at end of one month after stopping treatment. Compliance, satisfaction, and user acceptability were higher in ring users (80%) than pill users (70%) and a higher incidence of nausea was seen in pill group.Present study demonstrates for first time that both vaginal and oral hormonal therapy are effective in treatment of idiopathic chronic pelvic pain and vaginal ring may be a better choice with higher satisfaction rate and fewer side effects.


PubMed | University of Yazd, UCMS & GTB Hospital and LRGHealthcare
Type: Journal Article | Journal: Turkish journal of medical sciences | Year: 2016

India has 63 million diabetic people and the overall prevalence of diabetes in this country is 8.37%. Lifestyle modification by education is the most cost-effective strategy to have better metabolic control. The aim of this study was to investigate the effects of a self-management educational program on control of type 2 diabetes.It was a randomized controlled interventional study conducted among 306 patients with type 2 diabetes mellitus attending the Diabetic Clinic at G.T.B. Hospital, Delhi, from March 2010 to May 2013. The intervention was in the form of group education based on a self-management program, which was earlier developed in the pilot study.The baseline characteristics were comparable in the two groups. After 6 months, there was a significant improvement in the HbA1c levels (P = 0.0001), physical activity level (P = 0.001), and BMI (P = 0.001) in the study group as compared to the control group and this difference persisted even when analysis was done using generalized estimation equations.The findings of this study proved that a self-management educational program is an essential component in the management of diabetes and provided concrete evidence that this is an effective instrument in the control of body weight, blood pressure, and glycated Hb levels in type 2 diabetes.

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