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Chatterjee D.,Vardhaman Mahavir Medical College | Swamy M.K.S.,Vardhaman Mahavir Medical College | Gupta V.,Vardhaman Mahavir Medical College | Sharma V.,Vardhaman Mahavir Medical College | And 2 more authors.
JCRPE Journal of Clinical Research in Pediatric Endocrinology | Year: 2017

Objective: Stosstherapy has been used since early 19th century for treating nutritional rickets. However, there are no clear cut guidelines for the biochemical monitoring of this treatment. Repeated blood tests at short intervals increase the cost of therapy and noncompliance. Methods: A prospective study was conducted on 191 cases of nutritional rickets below 10 years of age to evaluate the effectivity of stosstherapy. All cases were treated with a single intramuscular injection of vitamin D (600.000 IU) along with oral calcium (50 mg/kg) and vitamin D (400 IU per day) until radiological resolution. Dietary modifications and adequate sunlight exposure were also recommended. Results: The mean age of presentation was 2 years 9 months. Mean sunlight exposure was 17 minutes/week with 90% having low sunlight exposure (<30 minutes/week). Prolonged breast feeding (>6 months) was found in 93.7% of the cases. With treatment, the clinical features started resolving by 1 month with complete resolution of most of the features over a period of 1 year. By 6 months, all the study subjects had complete radiological resolution. Serum levels of calcium and alkaline phosphatase (ALP) were restored by 6 months in most cases while phosphate and vitamin D levels normalized by 6 weeks. Conclusion: Stosstherapy is a safe, cheap and effective method of treating nutritional rickets. Biochemical tests at initial presentation followed by vitamin D assay at 6 weeks and calcium, phosphate and ALP assays at 6 months is recommended in the monitoring of these patients. For regular monitoring, only ALP assay is recommended, provided one abstains from repeat injection of vitamin D based on high ALP levels. © 2017 by Turkish Pediatric Endocrinology and Diabetes Society.


Parashar R.,All India Institute of Medical Sciences | Bhalla P.,Vardhaman Mahavir Medical College | Pakhare A.,All India Institute of Medical Sciences | Babbar R.,Maulana Azad Medical College
International Journal of Women's Health | Year: 2014

Background: Common neurological syndrome (migraine without aura) is more common among women than men. Migraine is among the top 20 causes of disability. Menstruation is known to be a powerful trigger for migraine, and so is stress, but the presentation of headache is similar in both. Also, women are more vulnerable to stress as well as migraine, and this makes a complex relationship of menstruation, stress, and migraine. Objective: This study was done to understand the association of hormonal fluctuation in menstruation and stress with common migraine. Materials and methods: A cross-sectional comparative study was conducted in 40 young adult females, of whom 20 participants were cases of migraine without aura (18-35 years old), and the remaining 20 participants were age-matched controls. The study was done in Maulana Azad Medical College, New Delhi. Study participants were selected on the basis of International Headache Society (ICHD-IIA1.1) (2004) classification. Study participants with neurological disorders, chronic diseases, and disease suggestive of any hormonal disturbances were excluded. Clinically diagnosed migraine cases were asked to maintain a headache diary and to fill in the Depression Anxiety Stress Scales questionnaire. Biochemical assessment of hormonal status for thyroid-stimulating hormone, triiodothyronine, thyroxine, estrogen, follicle-stimulating hormone, luteinizing hormone, and prolactin was also done on the second day of their menstrual cycle. We used the Mann-Whitney U test to compare hormonal levels and the χ2 test to compare anxiety- or depression-related stress among the migraine and nonmigraine groups. Results: Significantly higher values of prolactin were observed in cases (mean ± standard deviation, 152.7 mIU/L±30.5) compared to controls (76.1 mIU/L±8.7), with a P-value <0.001. There was no statistically significant difference observed in levels of thyroid-stimulating hormone (P=0.081), estrogen (P=0.086), luteinizing hormone (P=0.091), or follicle-stimulating hormone (P=0.478). Also, anxiety with stress or depression with stress was significantly higher among the migraine group than the controls (P=0.002). Odds of any stress in migraine were higher in the migraine group than in the nonmigraine group (odds ratio 12, 95% confidence interval 2.7-53.33). Conclusion: Migraine, particularly without aura, in women is mainly associated with stress-related anxiety or depression, and are more susceptible to stress in the premenstrual period. © 2014 Parashar et al.


Pakhiddey R.,Santosh Medical College | Paul S.,Lady Hardinge Medical College | Mandal A.K.,Vardhaman Mahavir Medical College | Kumar V.,Maulana Azad Medical College
Journal of the Anatomical Society of India | Year: 2015

Introduction: The role of androgens and androgen receptors (AR) in the pathophysiology of acne vulgaris appears to be a complex phenomenon. It has been suggested earlier that oral administration of isotretinoin, the drug of choice for severe cases of acne, exerts its action through ARs, which is quite debatable. The aim is to study the response of androgen receptor (AR) in the skin of acne vulgaris patients by administrating isotretinoin orally. Methods: Skin biopsy was procured from untreated patients of severe cases of acne vulgaris. Out of these, twenty histopathologically confirmed patients were included in the study. They were treated with oral isotretinoin in the dose of 0.5 mg/kg/day for 12 weeks, following which their skin biopsies were repeated. Immunostaining for androgen receptor was performed using mouse monoclonal antibodies. Androgen receptor index (AR index) was calculated for the acne patients before and following treatment with oral isotretinoin. Statistical analysis was done using paired t-test. Result: The AR indices in skin of untreated acne patients were higher in male patients (26.62 ± 20.74) as compared to the female patients (7.5 ± 10.61). AR indices after 12 weeks of oral isotretinoin treatment showed a reduction in both males and female patients (20.55 ± 16 and 4.71 ± 6.75 respectively). However, the post treatment reduction in AR index was statistically significant in male patients only. Discussion: Determination of AR status can be helpful in planning the treatment methodology of severe cases of acne. Our study also implicates the effectiveness of oral isotretinoin on acne patients through its interaction with androgen receptor. © 2015 Anatomical Society of India.


Gangopadhyay S.,P.A. College | Agrawal N.,Vardhaman Mahavir Medical College | Batra A.,Vardhaman Mahavir Medical College | Kabi B.C.,Vardhaman Mahavir Medical College | Gupta A.,P.A. College
Biochemical Genetics | Year: 2016

Polycystic ovarian syndrome (PCOS), a major cause of infertility, is also strongly associated with insulin resistance. Defects in insulin receptor signaling are considered as one of the major molecular pathogeneses for insulin resistance. To investigate the possible mechanism of this signaling defect at genetic level, single-nucleotide polymorphism (SNP) [His 1085 C/T] at the exon 17 of insulin receptor gene (INSR) was studied in this pilot study. Polymerase chain reaction was performed on leucocytic DNA of women diagnosed with PCOS, selected from the outpatient department of Safdarjung Hospital, New Delhi, using suitable primer to amplify a region on INSR. An equal number of age-matched healthy women were selected as controls. SNP analysis was performed with restriction enzyme length polymorphism technique using Pm II enzyme. Serum insulin level was measured by ELISA kit and HOMA-IR was calculated mathematically. A higher frequency of the CC genotype was observed in PCOS women than in controls. Also, HOMA-IR, a tool for estimating insulin resistance, was significantly high in PCOS women with the CC genotype. C1008T SNP at exon 17 of INSR is associated with insulin resistance in Indian women with PCOS. Presence of CC genotype (C1085T) could be developed as a marker for insulin resistance and metabolic complications in PCOS women. © 2015, Springer Science+Business Media New York.


Jayachandran V.,Vardhaman Mahavir Medical College
Annals of Tropical Medicine and Public Health | Year: 2014

Background: Defaulters are producing the challenging, daunting category of drug resistant cases. It is important to examine and understand the patient′s notions and terms to manage them effectively. Objective: To study the reasons behind failure of adherence to treatment and to assess the health care seeking behaviour with awareness of these patients regarding the public sector provisions. Materials and Methods: In depth interviews with ten patients who had defaulted and were undergoing CAT-II treatment which included both retreatment defaulters and new defaulters, were conducted by repeated contacts in Fatehpur Beri PHC DOTS centre. Results: People refuse to seek treatment from a government health centre when they fall sick seriously as they are ready to get treated at any expense and seek private health care facility for the prompt treatment. There is a notion that free service from public sector is not as effective as private corporate hospitals. In the public sector patients defaulted because of side effects of drugs, fear of getting admitted in big tuberculosis (TB) hospitals, incompatible timing, neglect, long waiting time, TB deaths in the family and lack of family support. Among migrants, lack of employers support, family support forced them to return home. Ignorance about existence of DOTS centre with free treatment was observed. Most of the patients were unaware that incomplete treatment could lead to disease. Misconceptions observed were that treatment was futile (talk in the community about drugs being useless) and most of the patients were afraid of the disease and thought they could die because of it. Conclusion: Proposed measures include: Recognition of traditional medicine/complementary alternative medicine practitioners for universal access to TB diagnosis and care, Public sector should be made attractive to the middle class society through enhancement of services and user fees and empowerment initiatives for lack of social support of the migrants.


Ravi K.S.,Vardhaman Mahavir Medical College | Mehta V.,Vardhaman Mahavir Medical College | Arora J.,Vardhaman Mahavir Medical College | Suri R.K.,Vardhaman Mahavir Medical College | Rath G.,Vardhaman Mahavir Medical College
Bratislava Medical Journal | Year: 2012

Objectives: Descriptions of the variant arterial pattern of upper limb are not exceptional and are therefore frequently reported in anatomy archives. Background: A noteworthy deviation from the usual branching pattern was observed unilaterally in a single cadaver. This unique division of axillary artery (AA) was present on the right side in an adult human cadaver of Indian origin. Results: The first part of axillary artery gave off the superior thoracic and thoraco-acromial arteries. Just proximal to the upper border of pectoralis minor the AA was observed to divide into two trunks a medial and a lateral. The lateral trunk continued into the brachium as the usual axillary artery where as the medial trunk displayed the other branches deep and distal to the pectoralis minor muscle. The remarkable feature was the wide caliber of the axillary artery where it bifurcated into two branches. An attempt has been made to dwell upon the embryological basis of the present anomaly. Conclusions: The relevance of anomalous arterial pattern of upper limb (U.L.) is realized while performing percutaneous arterial venous catheter insertion into subclavian vein via the infraclavicular route. We advocate a meticulous familiarization of the anatomy of axillary artery and its topographical relationship to other neurovascular structures for the operating plastic surgeon, anesthetist and radiologist.


PubMed | P.A. College and Vardhaman Mahavir Medical College
Type: Journal Article | Journal: Biochemical genetics | Year: 2016

Polycystic ovarian syndrome (PCOS), a major cause of infertility, is also strongly associated with insulin resistance. Defects in insulin receptor signaling are considered as one of the major molecular pathogeneses for insulin resistance. To investigate the possible mechanism of this signaling defect at genetic level, single-nucleotide polymorphism (SNP) [His 1085 C/T] at the exon 17 of insulin receptor gene (INSR) was studied in this pilot study. Polymerase chain reaction was performed on leucocytic DNA of women diagnosed with PCOS, selected from the outpatient department of Safdarjung Hospital, New Delhi, using suitable primer to amplify a region on INSR. An equal number of age-matched healthy women were selected as controls. SNP analysis was performed with restriction enzyme length polymorphism technique using Pm II enzyme. Serum insulin level was measured by ELISA kit and HOMA-IR was calculated mathematically. A higher frequency of the CC genotype was observed in PCOS women than in controls. Also, HOMA-IR, a tool for estimating insulin resistance, was significantly high in PCOS women with the CC genotype. C1008T SNP at exon 17 of INSR is associated with insulin resistance in Indian women with PCOS. Presence of CC genotype (C1085T) could be developed as a marker for insulin resistance and metabolic complications in PCOS women.


PubMed | Vardhaman Mahavir Medical College, All India Institute of Medical Sciences and Maulana Azad Medical College
Type: | Journal: International journal of women's health | Year: 2014

Common neurological syndrome (migraine without aura) is more common among women than men. Migraine is among the top 20 causes of disability. Menstruation is known to be a powerful trigger for migraine, and so is stress, but the presentation of headache is similar in both. Also, women are more vulnerable to stress as well as migraine, and this makes a complex relationship of menstruation, stress, and migraine.This study was done to understand the association of hormonal fluctuation in menstruation and stress with common migraine.A cross-sectional comparative study was conducted in 40 young adult females, of whom 20 participants were cases of migraine without aura (18-35 years old), and the remaining 20 participants were age-matched controls. The study was done in Maulana Azad Medical College, New Delhi. Study participants were selected on the basis of International Headache Society (ICHD-IIA1.1) (2004) classification. Study participants with neurological disorders, chronic diseases, and disease suggestive of any hormonal disturbances were excluded. Clinically diagnosed migraine cases were asked to maintain a headache diary and to fill in the Depression Anxiety Stress Scales questionnaire. Biochemical assessment of hormonal status for thyroid-stimulating hormone, triiodothyronine, thyroxine, estrogen, follicle-stimulating hormone, luteinizing hormone, and prolactin was also done on the second day of their menstrual cycle. We used the Mann-Whitney U test to compare hormonal levels and the (2) test to compare anxiety- or depression-related stress among the migraine and nonmigraine groups.Significantly higher values of prolactin were observed in cases (mean standard deviation, 152.7 mIU/L30.5) compared to controls (76.1 mIU/L8.7), with a P-value <0.001. There was no statistically significant difference observed in levels of thyroid-stimulating hormone (P=0.081), estrogen (P=0.086), luteinizing hormone (P=0.091), or follicle-stimulating hormone (P=0.478). Also, anxiety with stress or depression with stress was significantly higher among the migraine group than the controls (P=0.002). Odds of any stress in migraine were higher in the migraine group than in the nonmigraine group (odds ratio 12, 95% confidence interval 2.7-53.33).Migraine, particularly without aura, in women is mainly associated with stress-related anxiety or depression, and are more susceptible to stress in the premenstrual period.

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