Srinagar, India
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Nath B.,VCSGGMS and RI | Kumari R.,AIIMS | Tripathi A.,VCSGGMS and RI | Shukla A.,Rudraprayag | Midha T.,Government Medical College
Indian Journal of Tuberculosis | Year: 2015

Background: In 2013, an estimated 9.0 million people developed TB and 1.5 million died from the disease. India has achieved the target of a case detection rate of 70% and a cure rate of 85% through the nationwide Directly Observed Treatment Short Course (DOTS) strategy. Tuberculosis may generate residual lesions in the course of its pathology, which impair the functionality of the patient even after achieving "cure" or "treatment completion". Aims: To assess the presence of symptoms and functionality of tuberculosis patients who had completed the treatment or had been declared as cured under Revised National Tuberculosis Programme (RNTCP). Methods: The present study was a cross sectional study. It was conducted in the two Tuberculosis Units (TUs) of Rudraprayag and Pauri in Garhwal region of Uttarakhand among the people who had completed treatment under DOTS or had been declared as cured under RNTCP in last one year. Results: Even at the completion of the treatment about 37% had cough, 25% had expectoration, 6% had hemoptysis, more than 50% had chest pain and 65% had breathlessness. The mean distance walked by the participants in six minutes was 363.5 ± 58.2mwith a range of 245e490 m. Conclusions: The persistence of symptoms indicate that the functionality of DOTS cured patients remains compromised even after days and months of treatment completion, thereby necessitating measures for the improvement of the overall health of the patients rather than just the microbiological cure. © 2015 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.


Nath B.,VCSGGMS and RI | Midha T.,Government Medical College | Kumari R.,AIIMS | Gupta S.,GGSMC
Indian Journal of Community Health | Year: 2014

Background: Knowledge regarding Influenza A (H1N1) and its transmission and measures of prevention and control are important for individual protection as well as to contain the spread of the disease. Objective: To study the knowledge, attitude and practice regarding Influenza A (H1N1) among senior secondary school students of Kanpur. Study Design: A cross-sectional, questionnaire-based study. Material and Methods: This study was conducted among students of Class XI and XII of a leading private school in Kanpur. All the students present in the class at the time of the survey were included in the study. Results: Of the 483 students included in the study, 208 (43.1%) knew that it was a viral disease. Of all the students, 303 (62.7%) knew about the mode of transmission. Around 336 (69.6%) of the students knew that fever >38°C was a major symptom. Less commonly occurring symptoms such as diarrhoea (20.9%) and vomiting (14.3%) were known to few students. Conclusion: Knowledge regarding Influenza A (H1N1) needs to be enhanced among senior secondary school students through appropriate awareness programs. © 2014, INDIAN JOURNAL OF COMMUNITY HEALTH. All rights reserved.


Pathania M.,VCSGGMS and RI | Dutt H.K.,Kannur Medical College | Gogoi J.B.,Srikot | Rathaur V.,Srikot | And 2 more authors.
Journal of Clinical and Diagnostic Research | Year: 2016

Introduction: Diabetes is a major public health problem which needs to be addressed with outmost planning in resource poor settings. Good glycaemic control and medication adherence patterns can play an important role in reducing disease related complications thereby reducing morbidity and mortality among diabetics. Disease specific camps can act as a stepping stone in providing limited care to the patients. Aim: The study was planned to study the impact of diabetes camp on glycaemic control and adherence to antidiabetic medication among diabetic patients at a Government Teaching Hospital, Srinagar, Garhwal, Uttarakhand, India. Materials and Methods: A cross-sectional study using a medication adherence questionnaire collected from the patients participating in diabetic camps and measuring their HbA1C levels before and after the camps along with spreading awareness about the disease. Two diabetes awareness camps were organized, three month apart and the participants were imparted knowledge about the disease. A total of 50 patients with type 2 DM who had self reported history of diabetes and were on some form of oral anti diabetics confirmed by their prescriptions. The patients were called for monthly follow up in outpatient department. A six question preformed questionnaire – the Girerd’s instrument was used to assess the level of adherence to the prescribed anti-diabetic drugs in 50 patients with type 2 diabetes mellitus, their HbA1C levels were estimated and the results were analysed using standard statistical methods. Results: A total of 50 type 2 diabetic, 48 were studied comprising 23 (47.9%) women and 25 (52.1%) men with a mean age of 57.43 years. The average duration of diabetes among participants was 7.02 years. Poor medication adherence score was recorded in 27 participants and only 7 participants had good adherence to medication before the camp. After the camp, 19 participants had good adherence and 7 had poor medication adherence scores. As a result of improved adherence, improvement in glycaemic control was noticed by a decrease of 0.5 units in the mean HbA1C value by the end of the study. Conclusion: The results clearly showed that group intervention in the form of camp combined with monthly follow-ups could improve adherence as well as glycaemic control at a government teaching hospital in a resource poor setting. This could also involve and encourage society as well as young trainees to participate collectively in the care of diabetics. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved.


Pathania M.,VCSGGMS and RI | Rathaur V.K.,VCSGGMS and RI | Yadav N.,Intern Inc. | Jayara A.,Intern Inc. | Chaturvedi A.,VCSGGMS and RI
Journal of Clinical and Diagnostic Research | Year: 2013

Aims: This study aims at assessing the predictive value of random urine A:C ratio as a screening method for Micro-albuminuria assessment in DM patients as compared to 24 hours urine albumin. Settings and Design: A cross sectional observational study was conducted at a tertiary care centre. One hundred ninty three patients diagnosed with DM were enrolled in the study but 14 participants didn't turn up with 24 hours urine sample. Thus, 179 people actually participated in the study. Material and Methods: All DM patients who attended Out Patient Departments (OPDs) and In Patient Departments (IPDs) of Medicine, Surgery and Orthopaedics, were enrolled. Proper history about development and duration of DM was taken from the patients. Examination in the form of height and weight measurement to know Body Mass Index (BMI), the Waist: Hip Ratio (W:H ratio) calculated from waist and hip circumference and blood pressure measurement was done. Fasting blood sugar was measured in the study group. [Urine analysis was done for urinary albumin and urinary creatinine]. Two urine samples were collected from each participant; one, 24 hours sample and the other random urine sample. 24 hours urine samples were used to measure urinary albumin concentration while urinary albumin to creatinine ratio was measured from random urine sample. Statistical analysis used: SPSS 17. R esults: Twenty four hours RUA:C ratio has very good sensitivity and specificity of Sensitivity and specificity of 84.9% and 95.8% respectively,which makes it a better alternative to 24 hours UAC. Negative and positive predictive values of RUA:C ratio method are 0.93 and 0.090 respectively with false negative and false positive rates, 15.1% and 4.2 % respectively. C onclusion: Twenty four hours UAC is considered gold standard for screening of Micro-albuminuria but is cumbersome to collect 24 hours urine sample especially in OPD setup and in female patients. This leads to loss of compliance thereby preventing early diagnosis of diabetic nephropathy. This problem is more impracticable in hilly regions of India. By using random urine sample for screening of Micro-albuminuria in the form of RUA: C in random urine sample that correlates well with 24 hours UAC in 24 hours urine sample, is easier and more practical in Indian scenario especially in diabetics residing in hills.


Rathaur V.K.,VCSGGMS and RI | Pathania M.,VCSGGMS and RI | Jayara A.,VCSGGMS and RI | Yadav N.,VCSGGMS and RI
Journal of Clinical and Diagnostic Research | Year: 2014

Objective: There are not a large number of studies in India which can enlighten us regarding acute childhood diarrhoea and far lesser in number when it comes to its bacterial enteropathogenesis. The present study is specially targeted to determine the prevalence of various bacterial enteropathogens causing acute childhood diarrhoea & to find out their respective pattern of clinical features. Method: All children under 12 years of age enrolled between 1st June, 2012 and 31st July 2012, in the Outpatient department, Inpatient department of pediatrics section and casualty of hospital, who presented with acute diarrhoea. Data collected by mean of study questionnaire. Stool sample were processed for bacteriological analysis. In 280 samples bacteria were isolated with the help of microscopy, culture and biochemical reactions. The isolates obtained were tested for antimicrobial sensitivity over Mueller Hinton agar by Kirby Bauer disk diffusion method. Results: Out of 280 children frequency of diarrhoeagenic bacteria isolated from the samples showed that Escherichia coli was recorded as the predominant bacteria with 44.2% of prevalence followed by Shigella, Salmonella, Klebsiella and Campylobacter with 28.2%, 13.6%,7.8% and 6.1% respectively. Patients falling in the age group of 1-3 years. were the major sufferers of diarrhoea due to all etiologies except Klebsiella which mainly had impact on the patients below 6 months. Fever and vomiting were predominant symptoms. All 100% patients with Salmonella as etiology presented with fever. The maximum number of patients had frequency of diarrhoea less than 5 times a day (52.5%). And among the patients who presented with frequency of more than 10 times a day Salmonella was a major causative agent found. Maximum patients presented with some dehydration (67.1%) and the patients who presented with severe dehydration Salmonella was identified as a major etiological agent. Majority of isolated bacterial agents were resistant to Co-trimoxazole and Shigella being highly resistant enteropathogen isolated. Salmonella spp. were least resistant isolates. None of the isolates were resistant to Cefotaxime, Cefuroxime and Azetronam. Conclusion: Results of study reveal that Escherichia coli is a predominant bacterial enteropathogen causing diarrhoea and Salmonella is a major contributor to the diarrhoea causing severe dehydration and to the clinical features like fever, vomiting and more than 10 times of frequency of stools. Shigella is among highly resistant isolates while Salmonella isolates had least resistance to majority of antibiotics.


Pant N.K.,Government Medical College | Singh A.,V.C.S.G.G.M.S. and R.I. | Kumar D.,Delhi State Cancer Institute | Pandey H.,Government Medical College
ecancermedicalscience | Year: 2012

A phyllodes tumour of the breast converting to fibrosarcoma of the breast is a rare entity. Prognosis of fibrosarcoma of the breast is poor and the role of various treatment modalities is not clearly defined due to the rarity of the disease. One such case, which was treated successfully with a combination of surgery, radiotherapy and chemotherapy, is presented here. © the authors; licensee ecancermedicalscience.


Hatwal D.,VCSGGMS and RI | Chaudhari S.,VCSGGMS and RI | Joshi A.K.,VCSGGMS and RI | Rathaur V.K.,VCSGGMS and RI
Indian Journal of Community Health | Year: 2013

Background: Extrapulmonary Tuberculosis is an important clinical problem, defined as the isolated occurrence of tuberculosis in any part of the body other than lungs. Aim of the study is to describe the various presentations of extrapulmonary tuberculosis cases in children of Uttarakhand. Method: The children below 15 years included in the study from the pathology and pediatrics department of VCSG Govt. Medical. Science and Research Institute Srinagar Garhwal, private pathological centers, nursing homes and clinics at Srinagar Garhwal, Uttarakhand, during October 2010 to March 2012. The cases are selected on the basis of cytopathological and histopathological findings suggestive of tuberculosis. Cytologically suggestive cases of tuberculosis were further reviewed for detailed clinical status, conventional tests and response to antitubercular treatment to categorize the different types of extrapulmonary tuberculosis. Result: Out of 250 suspicious cases, 58 (23.2%) cases were of extrapulmonary tuberculosis. Out of 58 cases, lymph node tuberculosis in 24 (41.3%) was commonest, followed by tubercular meningitis in 22.4%, pleural effusion in13.7%, musculoskeletal in 12%,abdominal tuberculosis in 5.2 %, disseminated tuberculosis in 3.4% and cutaneous tuberculosis in only one case (1.7%). Cervical lymphnodes are the most common lymphnode involved (70.8%).Tissue cytology shows high sensitivity for acid fast bacilli on Ziehl- Neelsen staining. Fluid cytology showed high sensitivity (100%) for Adenosine deaminase (ADA) activity. All our cases responded to treatment and recovered well except two cases of tubercular meningitis. Conclusion: Although microbiological, and cyto-histopathological diagnosis are the gold standard but in our setup the patients having negative diagnostic test with strong clinical, radiographic and hematological investigations indicating tuberculosis were also treated on the line of tuberculosis. The diagnosis in latter was further strengthened by the positive response to the anti-tubercular treatment. Prompt and efficient identification of the source of transmission and application of effective environmental measures are intimately linked to the control of childhood tuberculosis.


PubMed | VCSGGMS and RI
Type: Journal Article | Journal: Annals of medical and health sciences research | Year: 2013

Mandibular fractures constitute a substantial proportion of cases of maxillofacial trauma. Demographic data related to mandibular fractures are difficult to evaluate because of many variables associated with the studies. The information is as diverse as the countries and the people who inhabit them.This is a retrospective study designed to determine the site distribution, associated fracture and causes of mandibular fractures in patients presenting to the trauma centre of Veer Chandra Singh Garhwali Government Medical Science and Research Institute, Uttarakhand, India.Records of 121 patients with confirmed mandibular fractures presenting over a three year period (i.e., 1(st) January 2008 to 31(st) December 2010). Data obtained from record included age, sex, site of fracture and causes.There were 48/121 (39.6%) males and 73/121 (60.3%) females. The most predominant age group of fracture was found to be 21-30 (53/121-43.8%) followed by 11-20 (25/121-20.6%). In this study history of fall was the most common cause of mandibular fracture (66/121-54.5%), followed by road traffic accidents (45/121-37.1%), fights and assault (08/121-6.6%) and industrial accidents (02/121-1.6%). In our study most of the patients suffered from fracture in the parasymphysis (35/139-25.1%) and angle region (32/139-23.0%) followed by body (30/139-21.5%), condyle (21/139-15.1%), symphysis (19/139-13.7%), and ramus (02/121-1.4%) area.In this study mandibular fractures were more prevalent in females especially during the second and third decade of life. History of fall was the most predominant cause of mandibular fracture. The most frequently affected sites were parasymphysis and angle.


PubMed | VCSGGMS and RI
Type: Journal Article | Journal: National journal of maxillofacial surgery | Year: 2013

Ophthalmic injuries commonly occur in patients with facial fractures. This study was set up to determine the incidence of ophthalmic injuries as assessed by an ophthalmologist, in patients who had sustained maxillofacial fractures.To determine the incidence of ophthalmic injuries in maxillofacial fractures in Indian population.A study of 136 patients who had sustained facial trauma sufficient to lead to a facial bone fracture was undertaken and the patients received a comprehensive examination by an ophthalmologist and an orthoptist within one week of injury. All the patients sustaining confirmed maxillofacial fractures were examined by an ophthalmologist for any associated ocular injury. The ophthalmic injuries were classified into three categories-mild, moderate, severe.Ninety-three patients (68.3%) examined sustained eye injuries of various types. Of these, 61.2% were temporary or minor, 29.03% were moderate, and 9.6% were serious. The highest incidence was found in association with mid face fractures, i.e., 95.7%. Fifty-seven patients sustained 176 minor ophthalmologic injuries; 27 patients suffered moderately; 33 had severe ophthalmic injuries. Nine patients sustained severe eye injuries.It is suggested that all traumas to the face, particularly above the level of the mouth, require a careful eye examination, including an estimation of visual acuity of each type.

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