Bala M.,Vardhman Mahavir Medical College and Safdarjung Hospital |
Kakran M.,Vardhman Mahavir Medical College and Safdarjung Hospital |
Singh V.,Vardhman Mahavir Medical College and Safdarjung Hospital |
Sood S.,AIIMS |
Ramesh V.,Vardhman Mahavir Medical College and Safdarjung Hospital
Sexually Transmitted Infections | Year: 2013
Objective The aim of the present study was to retrospectively analyse the data reported on antimicrobial resistance (AMR) in Neisseria gonorrhoeae in six South- East Asia Region countries from 2009 to 2012 following the revitalisation of the WHO global Gonococcal Antimicrobial Surveillance Program (GASP). Methods AMR data were generated for 7 antibiotics of 4675 isolates in 18 focal point laboratories using the calibrated dichotomous sensitivity (CDS) or Clinical and Laboratory Standards Institute (CLSI) methods and minimal inhibitory concentration testing by Etest in some of the centres. The results were interpreted using the breakpoints recommended. Results High-level resistance to traditional antibiotics, penicillin (25% to 100%) and tetracycline (10% to 100%) and the previously recommended ciprofloxacin (38% to 100%) was observed in all the countries. Overall, <90% of less susceptible and resistant isolates to penicillin and ciprofloxacin were identified from 15 laboratories. Decreased susceptibility to ceftriaxone and cefpodoxime was reported by nine and eight centres, respectively. Resistance to spectinomycin (0.6% to 10.5%) and azithromycin (>5%) was reported only by three centres. The increasing trends of resistance towards penicillin, tetracycline and ciprofloxacin were demonstrated in Bhutan, India, Sri Lanka and Thailand, and no large intercountry variations were evident. Insignificant trends in decreased susceptibility towards ceftriaxone were reported. Conclusions Expansion of the WHO GASP facilitated enhanced AMR surveillance to meet the ongoing challenges of control of gonococcal AMR. The results highlight that the emergence of decreased susceptibility to ceftriaxone and resistance to spectinomycin and azithromycin will unavoidably lead to loss of therapeutic options, and a search for new effective agents needs to be initiated to respond to the emergence of resistant isolates.
Agarwal K.A.,Vardhman Mahavir Medical College and Safdarjung Hospital |
Tripathi C.D.,Safdarjung Hospital |
Agarwal B.B.,Dr. Agarwals Surgery and Yoga |
Saluja S.,Sir Ganga Ram Hospital
Surgical Endoscopy and Other Interventional Techniques | Year: 2011
Objective: Better patient-reported outcomes (PROs) of laparoscopic cholecystectomy (LC) are premised upon PROs such as postoperative pain and fatigue. These PROs are indices of convalescence and return to normal activity. Curcumin (turmeric) is used in India for traumatic pain and fatigue for its anti-inflammatory/antioxidant and tissue modulation/healing properties. We studied the effect of curcumin on pain and postoperative fatigue in patients of LC. Methods and procedures: From July to September 2009, 50 consecutive day-care LC candidates were enrolled for a prospective, double-blind randomized placebo-controlled study. A uniform general anesthesia and analgesia protocol was followed. Curcumin/placebo and rescue analgesic were prescribed at discharge. Patients were told to maintain pain/fatigue/adverse event diaries based upon 100-point visual analog pain scale (VAS) and 10-point interval rating fatigue scale (IRS). Patients were followed up at third day (D3), first week (W1), second week (W2), and third week (W3). The blind labels were opened at the end of study. Results: Demographic characteristics, comorbidity, and gallbladder pathology profiles were comparable in the study (n = 25) and control groups (n = 25). There was no adverse surgical outcome, adverse PRO or withdrawal. Pain and fatigue scores at D3 were similar in the two groups. At W1 and W2, the study group showed significantly lower (p value 0.000) mean pain scores, i.e., 15 ± 5.204 versus 30 ± 13 in controls. Fatigue scores at W1, W2, and W3 were significantly lower (p value 0.000) in the study group, i.e., 2.16 ± 1.748, 1, and 0, respectively, versus 5.16 ± 1.375, 4.20 ± 1.633, and 1 in controls. All patients were pain free at W3. Analgesic tablet usage was significantly lower (p value 0.000) in the study group, i.e., 6.96 ± 1.837 versus 39.32 ± 16.509 in controls. Conclusions: Turmeric (curcumin) improves postoperative pain- and fatigue-related PROs following LC. © 2011 Springer Science+Business Media, LLC.
Yadav D.K.,Vardhman Mahavir Medical College and Safdarjung Hospital
BMJ case reports | Year: 2013
Haemangiomas are the most common tumours of infancy and early childhood. They are usually present in the neonate in the first 2 weeks of life. Haemangioma usually involves the head and neck area but less commonly involves the lumbosacral and perineal areas. Involvement of lumbosacral, perineal and other areas with associated anomalies are very rare. We present a neonatal case with extensive superficial haemangioma from the perineum to the neck along with multiple congenital anomalies.
Khokhar A.,Vardhman Mahavir Medical College And Safdarjung Hospital
Asian Pacific Journal of Cancer Prevention | Year: 2013
There is a consensus among researchers about the fact that women should be familiar with their breasts but there is a lot of argument as to how to make them aware of what is normal for them. For over decades breast self examination (BSE) was advocated for the same but as an outcome of work conducted by researchers in various countires a controversy has been raised in the West. In a country like India, where breast cancer screening is not popular and limited resources are available we should question what would be the best strategy to make women familiar with their breasts to facilitate best use of BSE.
Singh D.,Vardhman Mahavir Medical College and Safdarjung Hospital
Chinese journal of traumatology = Zhonghua chuang shang za zhi / Chinese Medical Association | Year: 2013
Simultaneous fracture/dislocation of the thumb carpometacarpal (CMC) joint and dislocation of the metacarpophalangeal (MCP) joint is considered as a rare injury pattern. We report an unusual case of dorsal dislocation of MCP joint of the thumb associated with extraarticular fracture of the base of the first metacarpal in a 28-year-old man. The dislocation of MCP joint had been missed during initial presentation at a peripheral centre. The patient made an uneventful recovery following open reduction and fixation with 1.25 mm Kirschner wire of the MCP joint along with repair of the ulnar collateral ligament. This injury pattern has not been previously reported to the best of our knowledge in the English-language based medical literature.
Khokhar A.,Vardhman Mahavir Medical College and Safdarjung Hospital
Asian Pacific Journal of Cancer Prevention | Year: 2012
A cross-sectional study was conducted among nursing staff of a missionary hospital of Delhi in June 2009. All the nurses were invited to participate in the training programme on breast cancer and techniques of breast self examination (BSE). A questionnaire was administered to all 259 participants seeking information on their level of awareness regarding breast cancer and relevant screening guidelines. With the help of 5 training workshops all the nurses were imparted training regarding the most appropriate technique of doing breast self exams. The mean age of the participants was 35.8 years. Out of a total of 259 nursing staff members 77.2% correctly answered all the 10 questions regarding high risk factors for breast cancer and after the training programme this increased to 100% (p<0.05). Only 65.2% of the participants gave correct responses to all the 8 questions regarding correct technique of performing a BSE, which after the training programme increased to 99.3% (p<0.05). At the baseline only 56.8% knew all the three screening methods correctly and after the intervention 98.7% could correctly mark the responses regarding screening (p<0.05). The actual practice of following the screening guidelines amongst the nursing staff was poor. Only 26 (10.03%) had ever done a BSE, none performed it monthly, 58 (22.4%) had ever gone themselves for a CBE and 18 (6. 94%) had ever undergone mammography.
Rath G.,Vardhman Mahavir Medical College and Safdarjung Hospital |
Jawanjal P.,Vardhman Mahavir Medical College and Safdarjung Hospital |
Salhan S.,Vardhman Mahavir Medical College and Safdarjung Hospital |
Nalliah M.,Dr Babasaheb Ambedkar Indian Rotary Cancer Hospital |
Dhawan I.,Vardhman Mahavir Medical College and Safdarjung Hospital
American Journal of Reproductive Immunology | Year: 2015
Problem: To determine the role of inactivated GSK3β with respect to Wnt/β-catenin pathway activation in HPV-16/18-associated cervical cancer. Method of study: The expression of active (pGSK3β-Try216), inactive (pGSK3β-Ser9), and c-Myc as well as HPV-16/18 infection was analyzed in cervical intra-epithelial neoplasia (CIN), squamous cell carcinoma (SCCs) and normal by immunohistochemistry and multiplex PCR. The proteins level was also compared with β-catenin and APC expression. Results: The dramatic decrease of pGSK3β-Try216 expression but ectopic overexpression of pGSK3β-Ser9 and c-Myc was observed both in CIN and SCCs samples compared to normal tissues. 57/67 CIN and 132/153 SCCs showed HPV-16 infection, while 3/67 CIN and 4/153 SCCs were harbored with HPV-18 infection. Both the proteins were significantly upregulated in HPV-16 infected cases (P = 0.0001; P = 0.001) and also positively correlated with nuclear β-catenin (P = 0.0001; P = 0.0001). Conclusion: The process of generation of HPV-16-associated cervical tumorigenesis is synergized with GSK3β inactivation and overactivation of Wnt/β-catenin pathway. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Tiwari P.,Vardhman Mahavir Medical College and Safdarjung Hospital
Indian journal of public health | Year: 2010
The objective of present study was to determine the profile and antimicrobial sensitivity pattern of bacteria isolated from various cultures in a tertiary hospital in Delhi. Culture and sensitivity of all blood, urine, pus, and throat sample reports obtained from May 2006 to April 2007 were analyzed from the central microbiology laboratory register. Among 6918 sample reports analyzed, about half (46%) of them were positive. The most commonly bacteria isolated in 35% of positive blood and pus samples was vancomycin-sensitive Staphylococcus aureus. Most common organism isolated in 54% of positive urine samples was imepenem-sensitive Escherichia coli.
Odukoya O.O.,University of Lagos |
Odeyemi K.A.,University of Lagos |
Oyeyemi A.S.,Niger Delta University |
Upadhyay R.P.,Vardhman Mahavir Medical College and Safdarjung Hospital
Asian Pacific Journal of Cancer Prevention | Year: 2013
Background: It is projected that low and middle-income countries will bear a major burden of tobacco related morbidity and mortality, yet, only limited information is available on the determinants of smoking initiation among youth in Africa. This study aimed to assess the determinants of smoking initiation and susceptibility to future smoking among a population of high school school students in Lagos, Nigeria. Materials and Methods: Baseline data from an intervention study designed to assess the effect of an anti-smoking awareness program on the knowledge, attitudes and practices of adolescents was analyzed. The survey was carried out in six randomly selected public and private secondary schools in local government areas in Lagos state, Nigeria. A total of 973 students completed self-administered questionnaires on smoking initiation, health related knowledge and attitudes towards smoking, susceptibility to future smoking and other factors associated with smoking. Results: Of the respondents, 9.7% had initiated smoking tobacco products with the predominant form being cigarettes (7.3%). Males (OR: 2.77, 95%CI: 1.65-4.66) and those with more pro-smoking attitudes (OR: 1.44, 95%CI: 1.34-1.54) were more likely to have initiated smoking. Those with parents and friends who are smokers were 3.47 (95%CI: 1.50-8.05) and 2.26 (95%CI: 1.27-4.01) times more likely to have initiated smoking. Non-smoking students, in privately owned schools (OR: 5.08), with friends who smoke (5.09), with lower knowledge (OR: 0.87) and more pro-smoking attitudes (OR 1.13) were more susceptible to future smoking. In addition, respondents who had been sent to purchase cigarettes by an older adult (OR: 3.68) were also more susceptible to future smoking. Conclusions: Being male and having parents who smoke are predictors of smoking initiation among these students. Consistent with findings in other countries, peers not only influence smoking initiation but also influence smoking susceptibility among youth in this African setting. Prevention programs designed to reduce tobacco use among in-school youth should take these factors into consideration. In line with the recommendations of article 16 of the WHO FCTC, efforts to enforce the ban on the sales of cigarettes to minors should be also emphasised.
Yadav R.,Vardhman Mahavir Medical College and Safdarjung Hospital |
Prakash Bhartiya J.,Vardhman Mahavir Medical College and Safdarjung Hospital |
Kumar Verma S.,Vardhman Mahavir Medical College and Safdarjung Hospital |
Kumar Nandkeoliar M.,Vardhman Mahavir Medical College and Safdarjung Hospital
Journal of Clinical and Diagnostic Research | Year: 2013
Background: Diabetes mellitus is a chronic metabolic disorder which is associated with hyperglycaemia. It is caused by a derangement in the secretion or function of the endocrinal portion of the pancreas. There is a close anatomical and functional relationship between its exocrine and endocrine portions. To address this issue, the current study was designed to evaluate the blood glucose and the amylase levels of diabetic patients as representatives of the two portions of the pancreas respectively. Aims and Objectives: The aim of the present study was to determine the blood glucose, serum amylase and the serum lipid profile in known cases of type 2 Diabetes Mellitus and to compare and correlate these parameters with those of age and sex matched healthy controls. Materials And Methods: One hundred ten patients of type 2 Diabetes mellitus, who were already diagnosed and were taking treatment, were included in this study. 30 age and sex matched healthy individuals were recruited as the control group in our study. Fasting venous blood samples were collected from the patients as well as the controls and they were analyzed by using an automated analyzer for blood glucose, serum amylase and the lipid profile (serum triglycerides, total cholesterol, high density lipoproteins and low density lipoproteins). The results were analyzed statistically by using the Student's "t" test and correlation coefficients. Results: Significantly low serum amylase levels were found in the diabetic patients as compared to those in the healthy controls (p value <0.001). Also, the levels of fasting serum total cholesterol, triglycerides and the low density lipoproteins were significantly higher in the patients as compared to those in the controls, with p values of <0.05, <0.001 and <0.001 respectively. The HDL (high density lipoprotein) level was found to be lower in the diabetic patients (p value <0.001). Conclusions: From our study, it was concluded that in type 2 Diabetes mellitus, wherever the blood glucose level was higher, the serum amylase activity was found to be significantly lower. This reflected the derangement in the endocrine-exocrine axis of the pancreas, as a disease which affected any portion of an organ would affect the adjoining area of that organ functionally. This fact must be kept in mind while the patients are treated.